Wal-Mart Stores Texas LLC
Wal-Mart Stores Texas LLC is a healthcare organization registered as Community/Retail Pharmacy in Mansfield, TX, holding Type 2 (organization) NPI 1104843218 since 2006. The authorized official on file is Kimberly Canonic, Senior Director, Enrollment.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1104843218 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Wal-Mart Stores Texas LLC |
| Other name | <Unavail> |
| Practice address | 930 N WALNUT CREEK DR STE 800, Mansfield, TX, 76063 |
| Phone | 8174733014 |
| Enumeration date | 2006-07-16 |
| Last updated in NPPES | 2025-05-30 |
Authorized official
| Name | Kimberly Canonic |
|---|---|
| Title | Senior Director, Enrollment |
| Phone | 4802776348 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 332B00000X | Durable Medical Equipment & Medical Supplies | Secondary | — | — |
| 333600000X | Pharmacy | Secondary | — | — |
| 3336C0003X | Community/Retail Pharmacy | Primary | 21623 | TX |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2090575 | Other | — | PK |
| 470237 | Medicaid | TX | — |
Copy-ready billing details
Provider: Wal-Mart Stores Texas LLC NPI: 1104843218 Taxonomy: 3336C0003X (Community/Retail Pharmacy) Address: 930 N WALNUT CREEK DR STE 800, Mansfield, TX, 76063
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1346322245 | Wal-Mart Stores Texas, Lp | Organization | Eyewear Supplier | Mansfield, TX |
| 1881295772 | Ejike Arinze | Individual | Pharmacist | Mansfield, TX |
Verify this record
Cross-check NPI 1104843218 against the authoritative CMS record: view Wal-Mart Stores Texas LLC on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
Where is Wal-Mart Stores Texas LLC located?
How current is this record?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2025-05-30.