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Wal-Mart Stores Texas LLC

Wal-Mart Stores Texas LLC is a healthcare organization registered as Community/Retail Pharmacy in Plano, TX, holding Type 2 (organization) NPI 1619242583 since 2012. The authorized official on file is Kimberly Canonic, Senior Director, Enrollment.

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NPI 1619242583
Entity type Organization (Type 2)
Legal business name Wal-Mart Stores Texas LLC
Other name <Unavail>
Practice address 3100 CUSTER RD, Plano, TX, 75075
Phone 9722446722
Enumeration date 2012-03-12
Last updated in NPPES 2025-06-05

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
3336C0003X Community/Retail Pharmacy Primary 27908 TX

Other identifiers

Identifier Type State Issuer
2134313 Other PK
469173 Medicaid TX
Copy-ready billing details
Provider: Wal-Mart Stores Texas LLC
NPI: 1619242583
Taxonomy: 3336C0003X (Community/Retail Pharmacy)
Address: 3100 CUSTER RD, Plano, TX, 75075

Providers at this address

NPI Name Type Specialty Location
1619914173 Albertsons LLC Organization Community/Retail Pharmacy Plano, TX
1962002451 Abey Thomas Individual Pharmacist Plano, TX
1376143958 Lisa Volesky Individual Pharmacist Plano, TX

Verify this record

Cross-check NPI 1619242583 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 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.

Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2025-06-05.