Update this page – If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS.
Organization
WAL-MART STORES TEXAS LLC
Active
Organization
WAL-MART STORES TEXAS LLC
Active
Other names
Walmart Pharmacy 10-4163
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 277-6348
Entity
Organization
Contact information
Practice address
2801 E WHITESTONE BLVD, CEDAR PARK, TX 78613-7273
(512) 690-9345
(512) 690-9346
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 204-8705
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28985
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1033535992
—
TX
01
—
2144785
PK
—
05
—
469753
—
TX
Enumeration date
03/14/2014
Last updated
06/06/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up