Wal-Mart Stores Texas LLC
Wal-Mart Stores Texas LLC is a healthcare organization registered as Community/Retail Pharmacy in Red Oak, TX, holding Type 2 (organization) NPI 1669747523 since 2012. The authorized official on file is Kimberly Canonic, Senior Director, Enrollment.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1669747523 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Wal-Mart Stores Texas LLC |
| Other name | <Unavail> |
| Practice address | 100 S RYAN DR, Red Oak, TX, 75154 |
| Phone | 9725152066 |
| Enumeration date | 2012-03-12 |
| Last updated in NPPES | 2025-06-19 |
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 | — | — |
| 3336C0003X | Community/Retail Pharmacy | Primary | 27907 | TX |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 469575 | Medicaid | TX | — |
| 2134311 | Other | — | PK |
Copy-ready billing details
Provider: Wal-Mart Stores Texas LLC NPI: 1669747523 Taxonomy: 3336C0003X (Community/Retail Pharmacy) Address: 100 S RYAN DR, Red Oak, TX, 75154
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1871868737 | Wal-Mart Stores Texas Lp | Organization | Eyewear Supplier | Red Oak, TX |
| 1316296213 | Seena Shyu | Individual | Optometrist | Red Oak, TX |
| 1386994184 | Oasis Eye Care, Pllc | Organization | Clinic/Center | Red Oak, TX |
| 1013536903 | Vu Nguyen | Individual | Pharmacist | Red Oak, TX |
| 1093316622 | Kelli Dulaney | Individual | Pharmacist | Red Oak, TX |
| 1619578200 | Maureen Walme-Brown | Individual | Pharmacist | Red Oak, TX |
| 1114528502 | Henry Knudson | Individual | Pharmacist | Red Oak, TX |
Verify this record
Cross-check NPI 1669747523 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?
What is a Type 2 NPI?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2025-06-19.