Wal-Mart Stores Texas, LLC

NPI #1265851018 in Copperas Cove, Texas

Provider Information

NPI Number
1265851018
Entity Type
Organization
Organization Name
Wal-Mart Stores Texas, LLC
Subpart
Yes (part of a larger organization)
Parent Organization
WAL-MART STORES, INC.
Primary Specialty
Nurse Practitioner
Enumeration Date
Apr 9, 2014
Last Updated
Feb 19, 2015

Practice Location

Address
2720 E BUSINESS 190
State
Texas
ZIP Code
76522-2584
Phone
(254) 661-6016

Authorized Official

Name
LAURA LEVINE
Title
DIRECTOR OF HEALTHCARE CONTRACTING
Phone
(479) 204-8550

Specialties & Taxonomy Codes

Specialty
Nurse Practitioner

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