# MC MEDICAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Walmart Care Clinic 10-3224, Walmart Health
- **Organization subpart:** No

## Provider details

- **NPI number:** 1841607082
- **Authorized official:** RICHARD HENRY (ENROLLMENT MANAGER)
- **Authorized official phone:** (479) 258-2080

## Contact information

- **Practice address:** 555 W INTERSTATE 30, GARLAND, TX 75043-5702
- **Practice address phone:** (972) 535-1562
- **Practice address fax:** (972) 303-2101
- **Mailing address:** 702 SW 8TH ST, BENTONVILLE, AR 72716-0445
- **Mailing address phone:** (479) 204-8550

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 07/21/2014
- **Last updated:** 11/23/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 358652ZHTN | MEDICARE PTAN | TX |