Wal-Mart Stores Texas, LLC

NPI #1992256325 in Tomball, Texas

Provider Information

NPI Number: 1992256325
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: Eyewear Supplier
Enumeration Date: Oct 20, 2016
Last Updated: Oct 20, 2016

Practice Location

Address: 25800 KUYKENDAHL ROAD
City: Tomball
State: Texas
ZIP Code: 77375
Phone: (832) 761-8494

Authorized Official

Name: LAURA LEVINE
Title: DIR HEALTHCARE CONTRACT&ENROLLMEN
Phone: (479) 204-8550

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician/Technologist - Optician — Optician	156FX1800X
Eyewear Supplier	332H00000X	Primary

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