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Organization
WALMART HEALTH NY TELEMEDICINE PLLC
Active
Organization
WALMART HEALTH NY TELEMEDICINE PLLC
Active
Other names
Pegus Telemedicine PLLC, Pulluru Telemedicine PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
MARK SHEN (OWNER)
(512) 779-7276
Entity
Organization
Contact information
Practice address
702 SW 8TH ST # MS 0215, BENTONVILLE, AR 72716-6209
(479) 258-2080
Mailing address
702 SW 8TH ST # MS 0215, BENTONVILLE, AR 72716-6209
(479) 258-2080
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103T00000X
Psychologist
—
—
104100000X
Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
2084P0800X
Psychiatry Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
04/26/2022
Last updated
02/13/2024
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