NPI age
8 years
Enumerated 2018-03-15
● Active Type 2 · Organization
Wal-Mart Stores Texas, Llc
Wal-Mart Stores Texas, Llc is 1 of 5625 pharmacy organizations in Texas.
Primary specialty
Pharmacy
Plus 2 secondary
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Canonic
Senior Director, Enrollment
Last NPPES update
2025-06-11
Source: monthly bulk 2026-05
How this organization compares
Across 5625 active pharmacy providers in Texas.
NPI age
8 years
↓ 7 yr below median
Practice locations
1
0 secondary on file
Subspecialties
2
In the 62% of peers with subspecialties
NPI lifetime · 2018 → 2026
2018-03Enumerated in NPPES
2018
2026
Where they practice
Primary practice location
5336 Golden Triangle Blvd
Fort Worth, TX 762444406
Mailing address
702 Sw 8th St
Bentonville, AR 727160445
Authorized official
Kimberly Canonic
Senior Director, Enrollment
📞 4808530515
Individual providers at this organization
2 individual providers on file at this primary practice address.
- Gabriel Boateng Pharmacist NPI 1902406150
- Amanda Gonzales, O.D. Optometrist NPI 1356657985
Specialties
-
Pharmacy PrimaryA pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the...
-
Durable Medical Equipment & Medical SuppliesA supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
-
PharmacyA facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 | 2177280 | PK |
Practice context
Multi-provider organization. 2 individual providers on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.