Organization · Type 2 NPI

Wal-Mart Stores Texas LLC

Eyewear Supplier · Fort Worth, TX

NPI number 1285978692 Active

Practice location

2900 Renaissance Square
Fort Worth, TX 76105

Call (817) 900-1912 Map

Mailing address

702 SW 8th St
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.

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NPI record

NPI: 1285978692
Entity type: Organization (Type 2)
Issued: Nov 26, 2012
Last updated: Nov 26, 2012
Status: Active
Subpart: Yes of Wal-Mart Stores Inc

Other names

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Wal-Mart Pharmacy 30-3044 · doing business as

Authorized official

Amy Powers
Specialist, Plan Enrollment
(479) 204-0709

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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 1285978692

Wal-Mart Stores Texas LLC's National Provider Identifier is 1285978692, issued on Nov 26, 2012. The primary taxonomy on file is Eyewear Supplier (332H00000X), and the practice location is in Fort Worth, TX. The record was last updated on Nov 26, 2012.