Wal-Mart Stores Texas LLC

NPI #1972924876 in Manor, Texas

Provider Information

NPI Number
1972924876
Entity Type
Organization
Organization Name
Wal-Mart Stores Texas LLC
Primary Specialty
Pharmacy - Community/Retail Pharmacy
Enumeration Date
Dec 18, 2013
Last Updated
Jun 6, 2025

Practice Location

Address
11923 US HIGHWAY 290 E
City
Manor
State
Texas
ZIP Code
78653-4321
Phone
(512) 651-9128

Authorized Official

Name
KIMBERLY CANONIC
Title
SENIOR DIRECTOR, ENROLLMENT
Phone
(480) 277-6348

Specialties & Taxonomy Codes

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

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