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Wal-Mart Stores Texas LLC

Community/Retail Pharmacy in Carrollton, TX · enumerated 2006 · authorized official Kimberly Canonic, Senior Director, Enrollment.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1215956222

Verified

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Registry record

Entity type Organization (Type 2)
Legal business name Wal-Mart Stores Texas LLC
Other name <Unavail>
Practice address 1025 W Trinity Mills Rd, Carrollton, TX, 75006
Fax (800) 406-8976
Enumeration date Jul 19, 2006
Last updated in NPPES Jun 12, 2025

Taxonomy & classification

3336C0003X Community/Retail Pharmacy Suppliers · License 99-200 (OK) Secondary
3336C0003X Community/Retail Pharmacy Suppliers · License 28RO00006000 (NJ) Secondary
3336C0003X Community/Retail Pharmacy Suppliers · License TX377 (KY) Secondary
3336C0003X Community/Retail Pharmacy Suppliers · License 400-0003 (SD) Secondary
3336C0003X Community/Retail Pharmacy Suppliers · License 126 (NE) Secondary
3336C0003X Community/Retail Pharmacy Suppliers · License 261465 (MN) Secondary
3336C0003X Community/Retail Pharmacy Suppliers · License 22-01391 (KS) Secondary
3336C0003X Community/Retail Pharmacy Suppliers · License PHA-MOP-LIC-37 (MT) Secondary
3336C0003X Community/Retail Pharmacy Suppliers · License 2002012999 (MO) Secondary
3336C0003X Community/Retail Pharmacy Suppliers · License 3242 (TN) Secondary
3336C0003X Community/Retail Pharmacy Suppliers · License 054.013662 (IL) Secondary
3336C0003X Community/Retail Pharmacy Suppliers · License 4785OS (LA) Secondary
3336C0003X Community/Retail Pharmacy Suppliers · License 64000067A (IN) Secondary
3336C0003X Community/Retail Pharmacy Suppliers · License 03779/7.1 (MS) Secondary
3336C0003X Community/Retail Pharmacy Suppliers · License OS01265 (AR) Primary

Authorized official

Name Kimberly Canonic
Title Senior Director, Enrollment

Other identifiers

Identifier Type State Issuer
100243640D Medicaid TX -
1215956222 Medicaid MT -
7100037990 Medicaid KY -
1020965500001 Medicaid PA -
166999407 Medicaid AR -
3810011244 Medicaid WV -
0162973 Medicaid TX -
1215956222 Medicaid VA -
4582517 Medicaid TN -
470020 Medicaid TX -
1215956222 Medicaid TX -
2095511 Other - PK
PH386 Medicaid TX -
0162973 Medicaid NJ -
200538680A Medicaid TX -
6031421 Medicaid WA -
613556 Medicaid TX -
7T2283 Medicaid SC -

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.

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Frequently asked questions

What is the NPI number for Wal-Mart Stores Texas LLC?
The NPI for Wal-Mart Stores Texas LLC is 1215956222, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for Wal-Mart Stores Texas LLC?
NPPES lists Kimberly Canonic (Senior Director, Enrollment) as the authorized official for this organization.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2025-06-12.