NPIMap

Organization Active NPI

Wal-Mart Stores Texas LLC

Doing business as Wal-Mart Pharmacy 30-3044

  • Eyewear Supplier
  • Fort Worth, TX
National Provider Identifier
1285978692
Registry record updated Nov 26, 2012
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
Wal-Mart Pharmacy 30-3044
Practice address
2900 Renaissance Square
Fort Worth, TX 76105
Phone
(817) 900-1912
NPI assigned
Nov 26, 2012
Last updated
Nov 26, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
WAL-MART STORES INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 26, 2012

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

Authorized official

Name
Amy Powers
Title
Specialist, Plan Enrollment
Phone
(479) 204-0709

Specialties & licenses 2

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

Addresses

Primary practice location

2900 Renaissance Square
Fort Worth, TX 76105

Mailing address

702 SW 8TH St
Bentonville, AR 72716-0445

Other names 1

  • Wal-Mart Pharmacy 30-3044 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 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": "1353888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353888000000",
    "number": "1285978692",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 RENAISSANCE SQUARE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76105",
            "telephone_number": "817-900-1912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAL-MART STORES TEXAS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WAL-MART STORES INC",
        "enumeration_date": "2012-11-26",
        "last_updated": "2012-11-26",
        "status": "A",
        "authorized_official_last_name": "POWERS",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "SPECIALIST, PLAN ENROLLMENT",
        "authorized_official_telephone_number": "479-204-0709"
    },
    "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": "Wal-Mart Pharmacy 30-3044",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2012; 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.