Wal-Mart Stores Texas LLC
Wal-Mart Stores Texas LLC is a healthcare organization registered as Community/Retail Pharmacy in Stafford, TX, holding Type 2 (organization) NPI 1720005960 since 2006. The authorized official on file is Kimberly Canonic, Senior Director, Enrollment.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1720005960 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Wal-Mart Stores Texas LLC |
| Other name | <Unavail> |
| Practice address | 11210 W AIRPORT BLVD, Stafford, TX, 77477 |
| Phone | 2819335252 |
| Enumeration date | 2006-07-16 |
| Last updated in NPPES | 2025-06-04 |
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 | — | — |
| 3336S0011X | Specialty Pharmacy | Secondary | — | — |
| 3336C0003X | Community/Retail Pharmacy | Primary | 21598 | TX |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 468435 | Medicaid | TX | — |
| 2096584 | Other | — | PK |
Copy-ready billing details
Provider: Wal-Mart Stores Texas LLC NPI: 1720005960 Taxonomy: 3336C0003X (Community/Retail Pharmacy) Address: 11210 W AIRPORT BLVD, Stafford, TX, 77477
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1881632503 | National Vision, Inc. | Organization | Eyewear Supplier | Stafford, TX |
| 1528120672 | Barun Hazra | Individual | Optometrist | Stafford, TX |
| 1689139412 | Elizabeth Hoang | Individual | Optometrist | Stafford, TX |
| 1538769492 | Wisler Geffrard | Individual | Pharmacist | Stafford, TX |
| 1851991624 | Felicia Obioha | Individual | Pharmacist | Stafford, TX |
| 1336744507 | Saba Medhin | Individual | Pharmacist | Stafford, TX |
| 1427824226 | Wal-Mart Stores Texas, LLC | Organization | Eyewear Supplier | Stafford, TX |
Verify this record
Cross-check NPI 1720005960 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 2025-06-04.