Wal-Mart Stores Texas LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

21829 Issued in TX

Legal business name

WAL-MART STORES TEXAS LLC

Doing business as

Wal-Mart Pharmacy 10-0597

Practice address

7075 FM 1960 Rd W
Houston, TX 77069-3601

Phone

(281) 893-1701

NPI assigned

Jul 16, 2006

Last updated

Jan 5, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Laura Levine

Title

MGR of Government Contracting

Phone

(479) 204-8550

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• WAL-MART PHARMACY 10-0597 Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Walmart Inc.

  dba Walmart Pharmacy 10-1588

  • Community/Retail Pharmacy
  • Victorville, CA
  • NPI 1043237456

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451952000000",
    "number": "1386661510",
    "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": "479-277-1238",
            "fax_number": "479-277-4331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7075 FM 1960 RD W",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770693601",
            "telephone_number": "281-893-1701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAL-MART STORES TEXAS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2016-01-05",
        "status": "A",
        "authorized_official_last_name": "LEVINE",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "MGR OF GOVERNMENT CONTRACTING",
        "authorized_official_telephone_number": "479-204-8550"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "21829",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2103458",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "462346",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WAL-MART PHARMACY 10-0597",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Wal-Mart Stores Texas LLC (Walmart Pharmacy 10-3296)
• Wal-Mart Stores Texas LLC (Wal-Mart Pharmacy)
• Wal-Mart Stores Texas LLC (Walmart Pharmacy 10-3302)
• Wal-Mart Stores Texas LLC (Walmart Pharmacy 10-3584)
• Wal-Mart Stores Texas LLC (Walmart Pharmacy 10-1137)
• Wal-Mart Stores Texas LLC (Walmart Pharmacy 10-0772)
• Wal-Mart Stores Texas LLC (Walmart Pharmacy 10-3297)
• Wal-Mart Stores Texas LLC (Wal-Mart Vision Center 30-3640)
• Wal-Mart Stores Texas LLC (Walmart Pharmacy 10-2718)
• Wal-Mart Stores Texas LLC (Walmart Pharmacy 10-3509)

• Community/Retail Pharmacy in Houston, TX
• Providers in Houston, TX by specialty
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.