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Wal-Mart Stores Texas LLC

Wal-Mart Stores Texas LLC is a healthcare organization registered as Community/Retail Pharmacy in Beaumont, TX, holding Type 2 (organization) NPI 1740207976 since 2006. The authorized official on file is Kimberly Canonic, Senior Director, Enrollment.

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NPI 1740207976
Entity type Organization (Type 2)
Legal business name Wal-Mart Stores Texas LLC
Other name <Unavail>
Practice address 4145 DOWLEN RD, Beaumont, TX, 77706
Phone 4098993615
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 21833 TX

Other identifiers

Identifier Type State Issuer
2103422 Other PK
469730 Medicaid TX
Copy-ready billing details
Provider: Wal-Mart Stores Texas LLC
NPI: 1740207976
Taxonomy: 3336C0003X (Community/Retail Pharmacy)
Address: 4145 DOWLEN RD, Beaumont, TX, 77706

Providers at this address

NPI Name Type Specialty Location
1780783126 Wal-Mart Stores Texas, Lp Organization Eyewear Supplier Beaumont, TX
1891269148 Hamza Gadit Individual Pharmacist Beaumont, TX
1881296390 Ankit Shah Individual Pharmacist Beaumont, TX
1932701356 Ayesha Syeda Individual Pharmacist Beaumont, TX
1194483529 Tien Nguyen Individual Pharmacist Beaumont, TX

Verify this record

Cross-check NPI 1740207976 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 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.
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).

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