Organization · Type 2 NPI

Wal-Mart Puerto Rico Inc

Eyewear Supplier · Bayamon, PR

NPI number 1164724233 Active

Practice location

1500 Ave Comerio
Bayamon, PR 00961-3976

Call (787) 740-0660 Map

Mailing address

1 Customer Dr, Ms 0445
Bentonville, AR 72716-0445

Specialties and licenses

Taxonomy	Code	License
Optician	156FX1800X	None listed
Eyewear Supplier Primary	332H00000X	None listed

Eyewear Supplier: An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.

Another provider at this address

Dorimar Mendez Santiago, DMDGeneral Practice Dentistry Bayamon, PR NPI 1386486538

Other eyewear supplier providers in Bayamon

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NPI record

NPI: 1164724233
Entity type: Organization (Type 2)
Issued: Nov 23, 2010
Last updated: Jul 17, 2026
Status: Active

Other names

<unavail>
Sam's Optical Center 30-6680 · doing business as
Sams Club Optical 30-6680 · doing business as

Authorized official

Kimberly Canonic
SR Director
(480) 853-0515

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1164724233

Wal-Mart Puerto Rico Inc's National Provider Identifier is 1164724233, issued on Nov 23, 2010. The primary taxonomy on file is Eyewear Supplier (332H00000X), and the practice location is in Bayamon, PR. The record was last updated on Jul 17, 2026.