Wal-Mart Stores Texas LLC

NPI #1669747523 in Red Oak, Texas

Provider Information

NPI Number
1669747523
Entity Type
Organization
Organization Name
Wal-Mart Stores Texas LLC
Primary Specialty
Pharmacy - Community/Retail Pharmacy
Enumeration Date
Mar 12, 2012
Last Updated
Jun 19, 2025

Practice Location

Address
100 S RYAN DR
State
Texas
ZIP Code
75154-4214
Phone
(972) 515-2066

Authorized Official

Name
KIMBERLY CANONIC
Title
SENIOR DIRECTOR, ENROLLMENT
Phone
(480) 853-0515

Specialties & Taxonomy Codes

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

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