Organization Name: | WAL-MART STORES TEXAS, LLC |
NPI Number: | 1598179335 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LAURA LEVINE (DIRECTOR, HEALTHCARE CONTRACTING AN) |
Mailing Address: | 411 South Broadway Street Elsa |
State: | TX US |
Postal Code: | 78543 |
Phone Number: | 9562629490 |
Fax Number: | |
NPI Enumeration Date: | 06/19/2014 |
NPI Last Update Date: | 07/15/2014 |
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: |