Wal-Mart Stores Texas LLC
Wal-Mart Stores Texas LLC is a healthcare organization registered as Community/Retail Pharmacy in Azle, TX, holding Type 2 (organization) NPI 1396762522 since 2006. The authorized official on file is Kimberly Canonic, Senior Director, Enrollment.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1396762522 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Wal-Mart Stores Texas LLC |
| Other name | <Unavail> |
| Practice address | 721 BOYD RD, Azle, TX, 76020 |
| Phone | 8172705838 |
| Enumeration date | 2006-07-16 |
| Last updated in NPPES | 2025-06-13 |
Authorized official
| Name | Kimberly Canonic |
|---|---|
| Title | Senior Director, Enrollment |
| Phone | 4808530515 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 332B00000X | Durable Medical Equipment & Medical Supplies | Secondary | — | — |
| 333600000X | Pharmacy | Secondary | — | — |
| 3336C0003X | Community/Retail Pharmacy | Primary | 24398 | TX |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2098803 | Other | — | PK |
| 469749 | Medicaid | TX | — |
| 24398 | Medicaid | TX | — |
Copy-ready billing details
Provider: Wal-Mart Stores Texas LLC NPI: 1396762522 Taxonomy: 3336C0003X (Community/Retail Pharmacy) Address: 721 BOYD RD, Azle, TX, 76020
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1144301581 | Wal-Mart Stores Texas, LLC | Organization | Eyewear Supplier | Azle, TX |
| 1861641326 | Joy Eye Care, P.L.L.C. | Organization | Optometrist | Azle, TX |
| 1245651645 | Roney Chaluparambil Marcos | Individual | Optometrist | Azle, TX |
| 1861978991 | Bichlien Tran | Individual | Pharmacist | Azle, TX |
| 1184100190 | Elfreda Osei | Individual | Community/Retail Pharmacy | Azle, TX |
| 1326652397 | Roma Patel | Individual | Pharmacist | Azle, TX |
| 1912723198 | Sydney Peauroi | Individual | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | Azle, TX |
| 1114723954 | Jimmara Alozie | Individual | Pharmacist | Azle, TX |
Verify this record
Cross-check NPI 1396762522 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 2025-06-13.