Organization
WAL-MART STORES TEXAS, LLC
Active
Parent organization
WAL-MART STORES INC
Other names
Wal-Mart Vision Center 30-0804
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAL-MART STORES INC
Authorized official
LAURA LEVINE (NPI COORDINATOR)
(479) 204-8550
Entity
Organization
Contact information
Practice address
601 FM 1821, MINERAL WELLS, TX 76067-9119
(940) 325-7808
Mailing address
702 SW 8TH ST, BENTONVILLE, AR 72716-0445
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Enumeration date
10/24/2006
Last updated
06/05/2013
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