Wal-Mart Stores Texas LLC
Wal-Mart Stores Texas LLC is a healthcare organization registered as Community/Retail Pharmacy in Lake Jackson, TX, holding Type 2 (organization) NPI 1912924150 since 2006. The authorized official on file is Kimberly Canonic, Senior Director, Enrollment.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1912924150 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Wal-Mart Stores Texas LLC |
| Other name | <Unavail> |
| Practice address | 121 HIGHWAY 332 W, Lake Jackson, TX, 77566 |
| Phone | 9792978578 |
| 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 | 21654 | TX |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2103889 | Other | — | PK |
| 469359 | Medicaid | TX | — |
Copy-ready billing details
Provider: Wal-Mart Stores Texas LLC NPI: 1912924150 Taxonomy: 3336C0003X (Community/Retail Pharmacy) Address: 121 HIGHWAY 332 W, Lake Jackson, TX, 77566
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1114026002 | Wal-Mart Stores Texas, Lp | Organization | Eyewear Supplier | Lake Jackson, TX |
| 1174713077 | Julie Nguyen | Individual | Optometrist | Lake Jackson, TX |
| 1013170729 | Dr. Julie T. Nguyen, Pllc | Organization | Optometrist | Lake Jackson, TX |
| 1649506981 | Kayla Dao | Individual | Optometrist | Lake Jackson, TX |
| 1326432550 | Howard Moyer | Individual | Pharmacist | Lake Jackson, TX |
| 1134639040 | Talal Altatar | Individual | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | Lake Jackson, TX |
| 1275019168 | Javeed Bora | Individual | Pharmacist | Lake Jackson, TX |
| 1720680812 | Devon Asphall | Individual | Pharmacist | Lake Jackson, TX |
Verify this record
Cross-check NPI 1912924150 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 2025-06-03.