NPIMap

Organization Active NPI

Wal-Mart Stores Texas, LLC

  • Eyewear Supplier
  • Celina, TX
National Provider Identifier
1629936240
Registry record updated May 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
WAL-MART STORES TEXAS, LLC
Practice address
400 Icy TRL
Celina, TX 75009-5780
Phone
(972) 382-0148
NPI assigned
Jan 13, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2026

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

Authorized official

Name
Kimberly Canonic
Title
Senior Director
Phone
(480) 853-0515

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OpticianGroup: 193200000X MULTI-SPECIALTY GROUP 156FX1800X
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

400 Icy TRL
Celina, TX 75009-5780

Mailing address

1 Customer Dr
Mail Stop 0445
Bentonville, AR 72716-0445

Other names 1

  • Walmart Vision Center 30-1250 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

NPI Registry JSON

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

{
    "created_epoch": "1768262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779840000000",
    "number": "1629936240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CUSTOMER DR",
            "address_2": "MAIL STOP 0445",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727160445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 ICY TRL",
            "city": "CELINA",
            "state": "TX",
            "postal_code": "750095780",
            "telephone_number": "972-382-0148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAL-MART STORES TEXAS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-13",
        "last_updated": "2026-05-27",
        "certification_date": "2026-05-27",
        "status": "A",
        "authorized_official_last_name": "CANONIC",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "SENIOR DIRECTOR",
        "authorized_official_telephone_number": "480-853-0515"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Walmart Vision Center 30-1250",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Celina, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2026; 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.