<Unavail>
LBN: Wal-Mart Stores Texas Llc
<Unavail> is an health care organization with primary practice located at 450 S Southeast Loop 323 , Tyler TX 75702-8646. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Pharmacy is the primary health care specialty.
Wal-Mart Stores Texas Llc can be contacted via phone (903) 405-6389, or through Canonic, Kimberly via phone (480) 853-0515.
Contact Information
Primary practice address
450 S Southeast Loop 323
Tyler TX 75702-8646
Phone: (903) 405-6389
Fax: (903) 405-6388
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | ||
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X |
Profile Details
| NPI number | 1245777895 |
|---|---|
| LBN Legal business name | Wal-Mart Stores Texas Llc |
| DBA Doing business as | <Unavail> |
| Authorized official | Canonic, Kimberly |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jan 20th, 2017 |
| Last updated | Jun 12th, 2025 - about last year |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1245777895 | NPPES |
| Texas | MEDICAID | 471170 | |
| Texas | Other | 2167668 |
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