# WAL-MART STORES TEXAS LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** WALMART PHARMACY 10-1279
- **Organization subpart:** No

## Provider details

- **NPI number:** 1710905518
- **Authorized official:** SARAH LITTLE (DIRECTOR OF HEALTHCARE CONTRACTING)
- **Authorized official phone:** (479) 277-2500

## Contact information

- **Practice address:** 10411 NORTH FWY \# 45, HOUSTON, TX 77037-1124
- **Practice address phone:** (281) 999-9963
- **Mailing address:** 702 SW 8TH ST, BENTONVILLE, AR 72716-0445
- **Mailing address phone:** (479) 277-1238
- **Mailing address fax:** (479) 277-4331

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 21906 | TX | Yes |
| 3336S0011X | Specialty Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 07/18/2006
- **Last updated:** 08/29/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2097827 | PK | — |
| 05 | — | 470333 | — | TX |