Wal-Mart Stores Texas LLC
Wal-Mart Stores Texas LLC is a healthcare organization registered as Community/Retail Pharmacy in Eagle Pass, TX, holding Type 2 (organization) NPI 1174540330 since 2006. The authorized official on file is Kimberly Canonic, Senior Director, Enrollment.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1174540330 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Wal-Mart Stores Texas LLC |
| Other name | <Unavail> |
| Practice address | 496 S BIBB AVE, Eagle Pass, TX, 78852 |
| Phone | 8307739001 |
| 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 | 21884 | TX |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2099857 | Other | — | PK |
| 154936202 | Medicaid | TX | — |
| 469772 | Medicaid | TX | — |
Copy-ready billing details
Provider: Wal-Mart Stores Texas LLC NPI: 1174540330 Taxonomy: 3336C0003X (Community/Retail Pharmacy) Address: 496 S BIBB AVE, Eagle Pass, TX, 78852
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1700983111 | Wal-Mart Stores Texas, Lp | Organization | Eyewear Supplier | Eagle Pass, TX |
| 1629678883 | Rafael Vidal | Individual | Pharmacist | Eagle Pass, TX |
| 1891395257 | Daniel Arreola | Individual | Pharmacist | Eagle Pass, TX |
| 1487254025 | Anita Ramos | Individual | Pharmacist | Eagle Pass, TX |
| 1982206850 | Zaida Flores | Individual | Pharmacist | Eagle Pass, TX |
Verify this record
Cross-check NPI 1174540330 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
What is the NPI number for Wal-Mart Stores Texas LLC?
Who is the authorized official for Wal-Mart Stores Texas LLC?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2025-05-30.