NPIMap

Organization Active NPI

Wal-Mart Stores Texas, LP

Doing business as Vision Center 30-1042

  • Eyewear Supplier
  • Bastrop, TX
National Provider Identifier
1083715585
Registry record updated May 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
WAL-MART STORES TEXAS, LP
Doing business as
Vision Center 30-1042
Practice address
488 Highway 71 W
Bastrop, TX 78602-3731
Phone
(512) 321-2288
NPI assigned
Sep 26, 2006
Last updated
May 14, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2025

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

Authorized official

Name
Nicole D Gentile
Title
Npi Coordinator
Phone
(316) 788-5580

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X NU Primary
Optician 156FX1800X NU

Addresses

Primary practice location

488 Highway 71 W
Bastrop, TX 78602-3731

Mailing address

702 SW 8TH Street
Bentonville, AR 72716-0235

Other names 1

  • Vision Center 30-1042 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

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

488 W State Highway 71
Bastrop, TX 78602
Phone (512) 303-2861

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747180800000",
    "number": "1083715585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 SW 8TH STREET",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727160235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "488 HIGHWAY 71 W",
            "city": "BASTROP",
            "state": "TX",
            "postal_code": "786023731",
            "telephone_number": "512-321-2288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAL-MART STORES TEXAS, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "status": "A",
        "authorized_official_last_name": "GENTILE",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "NPI COORDINATOR",
        "authorized_official_telephone_number": "316-788-5580"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vision Center 30-1042",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bastrop, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2025; 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.