WAL-MART STORES TEXAS LLC
NPI 1033535992
Pharmacy - Community/Retail Pharmacy in Cedar Park, TX

Q: What is Wal-Mart Stores Texas LLC's NPI number?

The NPI number for Wal-Mart Stores Texas LLC is 1033535992. It was assigned to this organization in the NPPES registry on March 14, 2014. The provider is doing business as Walmart Pharmacy 10-4163.

Q: What is Wal-Mart Stores Texas LLC's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Active since March 14, 2014

2801 E WHITESTONE BLVD, CEDAR PARK, TX 78613(512) 690-9345(512) 690-9346 Get Directions Write a Review

NPPES record last updated: June 6, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 6, 2025, Sep 1, 2023, Feb 15, 2017 and 1 more (4 updates tracked since 2016).

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About Wal-mart Stores Texas Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WAL-MART STORES TEXAS LLC (NPI 1033535992), doing business as Walmart Pharmacy 10-4163, is a healthcare organization registered as a community/retail pharmacy in Cedar Park, Texas and active in the NPI registry since March 2014. The organization lists Kimberly Canonic, Senior Director, Enrollment, as its authorized official.

NPPES Registry Identity

NPI1033535992

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business NameWAL-MART STORES TEXAS LLC

Location Address2801 E WHITESTONE BLVDCedar Park, TX 78613-7273

Mailing Address702 Sw 8th StBentonville, AR 72716-0445 · (479) 204-8705 · Fax (479) 277-4331

Phone(512) 690-9345

Fax(512) 690-9346

Organization SubpartNo

Authorized OfficialKimberly CanonicSenior Director, Enrollment · (480) 277-6348

Enumeration DateMarch 14, 2014

Last NPPES UpdateJune 6, 20254 updates tracked since enumeration

NPPES CertifiedJune 6, 2025

✔ NPI 1033535992 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers

Taxonomy Code3336C0003X

License✔ Licensed in TX · 28985

Definition

A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X

2801 E WHITESTONE BLVD, Cedar Park, TX 78613

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Other Names 1

Doing Business AsWalmart Pharmacy 10-4163

Other Identifiers 3

Medicaid469753TX

Medicaid1033535992TX

Other2144785Pk

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

173 services168 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

171 services166 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

39 services39 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

33 services33 patients

Medical Equipment Supplier Medicare DMEPOS 12

Medicare supplier enrollment and the product categories Walmart Pharmacy 10-4163 carries, from the Medicare DMEPOS supplier directory.

Walmart Pharmacy 10-4163

DMEPOS supplier · Cedar Park, TXOperated by Wal-Mart Stores Texas, LLC

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Does not accept Medicare assignment

Walmart Pharmacy 10-4163 has not agreed to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients may be charged more than the Medicare-approved amount; confirm the expected cost with the supplier before ordering.

PTAN (Medicare Supplier Number)20610179

Medicare Participant SinceNovember 29, 2001

Supplier Location2801 E Whitestone BlvdCedar Park, TX 78613

Phone(512) 690-9345

Supplier Specialties

Pharmacy Optician

Medicare Product Categories

Epoetin

Epoetin is a man-made version of human erythropoietin (EPO)

Immunosuppressive Drugs

Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant

Infusion Drugs

Nebulizer Drugs

Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect

Oral Anticancer Drugs

FDA anticancer drugs

Oral Antiemetic Drugs

FDA antiemetic drugs

Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JINGE CHEN

Pharmacist