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WAL-MART STORES TEXAS LLC
NPI 1285168039
Pharmacy in Prosper, TX

Active since April 19, 2017
500 RICHLAND BOULEVARD, PROSPER, TX 75078(972) 347-9572(972) 347-9591 Get Directions Write a Review

NPPES record last updated: June 12, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 12, 2025, Apr 20, 2018, Jan 18, 2018 and 2 more (5 updates tracked since 2017).

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 1285168039) is a healthcare organization registered as a pharmacy in Prosper, Texas and active in the NPI registry since April 2017. The organization lists Kimberly Canonic, Senior Director, Enrollment, as its authorized official.

NPPES Registry Identity

NPI1285168039
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWAL-MART STORES TEXAS LLC
Location Address500 RICHLAND BOULEVARDProsper, TX 75078
Mailing Address702 Sw 8th StBentonville, AR 72716-0445 · (479) 204-8550 · Fax (479) 277-4331
Phone(972) 347-9572
Fax(972) 347-9591
Organization SubpartNo
Authorized OfficialKimberly CanonicSenior Director, Enrollment · (480) 853-0515
Enumeration DateApril 19, 2017
Last NPPES UpdateJune 12, 20255 updates tracked since enumeration
NPPES CertifiedJune 12, 2025
✔ NPI 1285168039 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
License✔ Licensed in TX · 31275
Definition
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
Also ListedPharmacy · Community/Retail PharmacyTaxonomy 3336C0003X
500 RICHLAND BOULEVARD, Prosper, TX 75078
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Other Identifiers 2

Other2172762Pk
Medicaid471217TX

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.
121 services119 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.
117 services115 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.
19 services19 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.
16 services16 patients

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

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

The NPI number for Wal-Mart Stores Texas LLC is 1285168039. It was assigned to this organization in the NPPES registry on April 19, 2017.

Where is Wal-Mart Stores Texas LLC located?

Wal-Mart Stores Texas LLC is located at 500 Richland Boulevard, Prosper, TX 75078. The listed phone number is (972) 347-9572.

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

The primary specialty registered for this NPI is Pharmacy with taxonomy code 333600000X.

What insurance does Wal-Mart Stores Texas LLC accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 56 other insurers list Wal-Mart Stores Texas LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Wal-Mart Stores Texas LLC was last updated on June 12, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.