OrganizationActive
Wal-Mart Stores Texas LLC
NPI 1790125508 · Community/Retail Pharmacy · Crossroads, TX
Provider details
- NPI number
- 1790125508
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Kimberly Canonic, Senior Director, Enrollment(480) 853-0515
Specialties & taxonomies
Suppliers
Suppliers
Practice location
11700 US Highway 380
Crossroads, TX 76227-8200
Phone: (940) 488-7011
Fax: (940) 488-7012
Approximate (ZIP-level) locationGet directions
Mailing address
702 Sw 8th St
Bentonville, AR 72716-0445
Other names (DBA / former)
- Doing business as
- Walmart Pharmacy 10-5707
Registry dates
- Enumerated
- 2013-06-26
- Last updated
- 2025-07-07
- Certified
- 2025-07-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.