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Wal-Mart Stores Texas LLC

Community/Retail Pharmacy in Desoto, TX · enumerated 2014 · authorized official Kimberly Canonic, Senior Director, Enrollment.

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

National Provider Identifier

1396148193

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 108 W Parkerville Rd, Desoto, TX, 75115
Phone (469) 643-5017
Fax (469) 643-5014
Enumeration date Oct 7, 2014
Last updated in NPPES Jun 12, 2025

Taxonomy & classification

332B00000X Durable Medical Equipment & Medical Supplies Suppliers Secondary
3336C0003X Community/Retail Pharmacy Suppliers · License 29603 (TX) Primary

Authorized official

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

Other identifiers

Identifier Type State Issuer
2148850 Other — PK
470007 Medicaid TX —

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 type of organization is Wal-Mart Stores Texas LLC?
Wal-Mart Stores Texas LLC is registered in NPPES as a Community/Retail Pharmacy (its primary provider taxonomy).
What is a Type 2 NPI?
A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.

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