NPIMap

Organization Active NPI

Wal-Mart Stores Texas, LLC

  • Community/Retail Pharmacy
  • Penitas, TX
National Provider Identifier
1043496482
Registry record updated Jan 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
WAL-MART STORES TEXAS, LLC
Practice address
1705 Expressway 83
Penitas, TX 78576
Phone
(956) 580-6840
NPI assigned
Jan 16, 2008
Organization subpart
Yes
Parent organization
WAL-MART STORES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 16, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Donna Parsley
Title
Third Party Enrollment Manager
Phone
(479) 277-1242

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

1705 Expressway 83
Penitas, TX 78576

Mailing address

702 SW 8TH St.
Bentonville, AR 72716-0445
Phone (479) 277-1242

Other names 1

  • Wal-Mart Pharmacy 10-4508 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Wal-Mart Stores Teas LLC879 organizations share this tax ID, including this one
Part of
Walmart Pharmact

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

1705 Expressway 83
Penitas, TX 78576
Phone (956) 580-1511

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1200441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200441600000",
    "number": "1043496482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 SW 8TH ST.",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727160445",
            "telephone_number": "479-277-1242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1705 EXPRESSWAY 83",
            "city": "PENITAS",
            "state": "TX",
            "postal_code": "78576",
            "telephone_number": "956-580-6840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAL-MART STORES TEXAS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WAL-MART STORES, INC.",
        "enumeration_date": "2008-01-16",
        "last_updated": "2008-01-16",
        "status": "A",
        "authorized_official_last_name": "PARSLEY",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "THIRD PARTY ENROLLMENT MANAGER",
        "authorized_official_telephone_number": "479-277-1242"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wal-Mart Pharmacy 10-4508",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Penitas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.