| NPI | 1083631253 |
|---|---|
| NPI Type | NPI-2 Organization |
| Status | Active |
| Enumeration Date | 2006-07-16 |
| Last Updated | 2025-06-03 |
| Authorized Official | Kimberly Canonic Senior Director, Enrollment Phone: 4802776348 |
| Mailing Address | 702 Sw 8th St Bentonville, AR 72716-0445 United States Phone: (479) 277-1242 | Fax: (479) 277-4331 📍 View Map |
| Primary Practice Address | 1200 W Main St Gun Barrel City, TX 75156-5320 United States Phone: (903) 887-2133 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| Other (non-Medicare) | — | 2100600 | PK |
| MEDICAID | TX | 469159 | — |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| No | 332B00000X – Durable Medical Equipment & Medical Supplies | — | — |
| No | 333600000X – Pharmacy | — | — |
| Yes | 3336C0003X – Pharmacy, Community/Retail Pharmacy | TX | 21587 |
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About NPI 1083631253
Wal-Mart Stores Texas Llc is an organization registered in the CMS NPPES NPI Registry with NPI number 1083631253. The primary specialty listed is Pharmacy, Community/Retail Pharmacy. The organization is located in Gun Barrel City, TX. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2006-07-16. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1083631253?
NPI 1083631253 belongs to Wal-Mart Stores Texas Llc, a Pharmacy, Community/Retail Pharmacy in Gun Barrel City, TX. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.
Is NPI 1083631253 active?
The current status of NPI 1083631253 in the NPPES registry is Active. The record was last updated on 2025-06-03.
What specialty is NPI 1083631253?
NPI 1083631253 is classified under the taxonomy Pharmacy, Community/Retail Pharmacy. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1083631253?
You can verify NPI 1083631253 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1083631253?
The primary practice address on file for NPI 1083631253 is 1200 W Main St, Gun Barrel City, TX 75156-5320. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1083631253 issued?
NPI 1083631253 was first issued (enumerated) on 2006-07-16. The NPPES record was last updated on 2025-06-03.
Practice Location Map
Wal-Mart Stores Texas Llc is located at 1200 W Main St, Gun Barrel City, TX. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Wal-Mart Stores Texas Llc. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1083631253. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Pharmacy, Community/Retail Pharmacy | 21587 | TX |