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Wal-Mart Stores Texas LLC

Community/Retail Pharmacy in San Angelo, TX · enumerated 2016 · authorized official Kimberly Canonic, Senior Director, Enrollment.

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

National Provider Identifier

1497115794

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Registry record

Entity type Organization (Type 2)
Legal business name Wal-Mart Stores Texas LLC
Other name <Unavail>
Practice address 3440 S Bryant Blvd, San Angelo, TX, 76903
Enumeration date Feb 29, 2016
Last updated in NPPES Jun 9, 2025

Taxonomy & classification

332B00000X Durable Medical Equipment & Medical Supplies Suppliers Secondary
333600000X Pharmacy Suppliers Secondary
3336C0003X Community/Retail Pharmacy Suppliers · License 30580 (TX) Primary

Authorized official

Name Kimberly Canonic
Title Senior Director, Enrollment

Other identifiers

Identifier Type State Issuer
470088 Medicaid TX -
2159148 Other - PK

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

Where is Wal-Mart Stores Texas LLC located?
The practice location on file with NPPES is in San Angelo, TX.
How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2025-06-09. Verify at npiregistry.cms.hhs.gov.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2025-06-09.