Organization Name: | WAL-MART STORES TEXAS, LLC |
NPI Number: | 1679605000 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LAURA LEVINE (MGR GOV CONTRACTING) |
Mailing Address: | 109 22nd St Hondo |
State: | TX US |
Postal Code: | 788612514 |
Phone Number: | 8304264356 |
Fax Number: | |
NPI Enumeration Date: | 03/12/2007 |
NPI Last Update Date: | 06/05/2013 |
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: |