Wal-Mart Stores Texas LLC

NPI #1295869899 in Longview, Texas

Provider Information

NPI Number
1295869899
Entity Type
Organization
Organization Name
Wal-Mart Stores Texas LLC
Primary Specialty
Pharmacy - Community/Retail Pharmacy
Enumeration Date
Mar 15, 2007
Last Updated
Jul 8, 2025

Practice Location

Address
4006 ESTES PKWY
State
Texas
ZIP Code
75603-1712
Phone
(903) 234-2083

Authorized Official

Name
KIMBERLY CANONIC
Title
SENIOR DIRECTOR, ENROLLMENT
Phone
(480) 371-1168

Specialties & Taxonomy Codes

Specialty
Durable Medical Equipment & Medical Supplies
Pharmacy - Community/Retail PharmacyCommunity/Retail Pharmacy

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