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Wal-Mart Stores Texas LLC

Wal-Mart Stores Texas LLC is a healthcare organization registered as Community/Retail Pharmacy in San Angelo, TX, holding Type 2 (organization) NPI 1649297813 since 2006. The authorized official on file is Kimberly Canonic, Senior Director, Enrollment.

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NPI 1649297813
Entity type Organization (Type 2)
Legal business name Wal-Mart Stores Texas LLC
Other name <Unavail>
Practice address 5501 SHERWOOD WAY, San Angelo, TX, 76904
Phone 3259427682
Enumeration date 2006-07-16
Last updated in NPPES 2025-06-03

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
333600000X Pharmacy Secondary
3336C0003X Community/Retail Pharmacy Primary 21830 TX

Other identifiers

Identifier Type State Issuer
066284302 Medicaid TX
469179 Medicaid TX
2101509 Other PK
Copy-ready billing details
Provider: Wal-Mart Stores Texas LLC
NPI: 1649297813
Taxonomy: 3336C0003X (Community/Retail Pharmacy)
Address: 5501 SHERWOOD WAY, San Angelo, TX, 76904

Providers at this address

NPI Name Type Specialty Location
1700968286 Wal-Mart Stores Texas, Lp Organization Eyewear Supplier San Angelo, TX
1225192917 Thomas Blankenship Individual Optometrist San Angelo, TX
1851991277 Yen Carroll Individual Pharmacist San Angelo, TX
1801496286 Bryan Mccullough Individual Pharmacist San Angelo, TX
1033710678 Zainab Olayiwola Individual Pharmacist San Angelo, TX
1346133980 Caplan Eye Associates Organization Optometrist San Angelo, TX

Verify this record

Cross-check NPI 1649297813 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

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.
What is the NPI number for Wal-Mart Stores Texas LLC?
The NPI for Wal-Mart Stores Texas LLC is 1649297813, a Type 2 (organization) record in the CMS NPPES registry.

Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2025-06-03.