Organization
WAL-MART STORES TEXAS LLC
Active
Other names
Walmart Pharmacy 10-4512
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CANONIC (SENIOR DIRECTOR, ENROLLMENT)
(480) 853-0515
Entity
Organization
Contact information
Practice address
22850 MORTON RANCH RD, KATY, TX 77449-2154
(346) 307-8161
(346) 307-8160
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
(479) 204-1242
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2168648
PK
—
Enumeration date
02/03/2017
Last updated
06/11/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us