NPIMap

Organization Active NPI

Wal-Mart Stores Texas, LLC

Doing business as Walmart Vision Center 30-4503

  • Eyewear Supplier
  • Grand Prairie, TX
National Provider Identifier
1104352459
Registry record updated May 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
WAL-MART STORES TEXAS, LLC
Doing business as
Walmart Vision Center 30-4503
Practice address
24403 Ih 10W
Grand Prairie, TX 75052
Phone
(479) 277-1242
Fax
(479) 277-4331
NPI assigned
May 5, 2017
Last updated
May 5, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
WAL-MART STORES, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 5, 2017

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

Authorized official

Name
Kylee Fisher
Title
Manager
Phone
(479) 204-1258

Specialties & licenses 2

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

Addresses

Primary practice location

24403 Ih 10W
Grand Prairie, TX 75052

Mailing address

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

Other names 1

  • Walmart Vision Center 30-4503 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Wal-Mart Store Texas LP879 organizations share this tax ID, including this one
Part of
Walmart Pharmacy 10-206

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

NPI Registry JSON

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

{
    "created_epoch": "1493942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493942400000",
    "number": "1104352459",
    "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",
            "fax_number": "479-277-4331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24403 IH 10W",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "75052",
            "telephone_number": "479-277-1242",
            "fax_number": "479-277-4331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAL-MART STORES TEXAS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WAL-MART STORES, INC",
        "enumeration_date": "2017-05-05",
        "last_updated": "2017-05-05",
        "status": "A",
        "authorized_official_last_name": "FISHER",
        "authorized_official_first_name": "KYLEE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "479-204-1258"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Walmart Vision Center 30-4503",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Prairie, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2017; 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.