| Organization Name: | WAL-MART STORES TEXAS, LLC |
| NPI Number: | 1437540150 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LAURA LEVINE (DIRECTOR OF HEALTHCARE CONTRACTING) |
| Mailing Address: | 1004 W Ocean Blvd Los Fresnos |
| State: | TX US |
| Postal Code: | 785663666 |
| Phone Number: | 9562331822 |
| Fax Number: | 9562331797 |
| NPI Enumeration Date: | 02/17/2015 |
| NPI Last Update Date: | 02/17/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 156FX1800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Technician/Technologist |
| Taxonomy Specialization: | Optician |
| Taxonomy Definition: | |