Organization
WAL-MART STORES TEXAS, LLC
Active
Parent organization
WAL-MART STORES, INC.
Other names
Walmart Vision Center 30-7281
Organization subpart
Yes
Provider details
NPI number
Legal business name
WAL-MART STORES, INC.
Authorized official
LAURA LEVINE (DIR HEALTHCARE CONTRACT&ENROLMENT)
(479) 204-8550
Entity
Organization
Contact information
Practice address
3440 S. BRYANT BLVD, SAN ANGELO, TX 76903
(325) 276-6598
(325) 276-6597
Mailing address
702 SW 8TH ST, MAILSTOP 0445, BENTONVILLE, AR 72716-0445
(479) 204-8550
(479) 277-4331
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
—
—
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
470088
—
TX
Enumeration date
02/29/2016
Last updated
05/11/2016
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