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WAL-MART STORES TEXAS LLC
NPI 1386088078
Pharmacy - Community/Retail Pharmacy in Tyler, TX

Active since April 24, 2013
1900 E SE LOOP 323, TYLER, TX 75701(903) 508-6127(903) 508-6128 Get Directions Write a Review

NPPES record last updated: June 9, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 9, 2025, Feb 15, 2017, Aug 30, 2016 (3 updates tracked since 2016).

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 1386088078), doing business as Walmart Pharmacy 10-4193, is a healthcare organization registered as a community/retail pharmacy in Tyler, Texas and active in the NPI registry since April 2013. The organization lists Kimberly Canonic, Senior Director, Enrollment, as its authorized official.

NPPES Registry Identity

NPI1386088078
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameWAL-MART STORES TEXAS LLC
Location Address1900 E SE LOOP 323Tyler, TX 75701-8337
Mailing Address702 Sw 8th StBentonville, AR 72716-0445 · (479) 277-1242 · Fax (479) 204-4331
Phone(903) 508-6127
Fax(903) 508-6128
Organization SubpartNo
Authorized OfficialKimberly CanonicSenior Director, Enrollment · (480) 277-6348
Enumeration DateApril 24, 2013
Last NPPES UpdateJune 9, 20253 updates tracked since enumeration
NPPES CertifiedJune 9, 2025
✔ NPI 1386088078 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 · 28556
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
1900 E SE LOOP 323, Tyler, TX 75701
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Other Names 1

Doing Business AsWalmart Pharmacy 10-4193

Other Identifiers 3

Other2141005Pk
Medicaid470189TX
Medicaid1386088078TX

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 3

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.
100 services97 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.
97 services94 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.
13 services13 patients

Other Providers at the Same Location NPPES

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

ALBERTSONS LLC
Pharmacy (Community/Retail Pharmacy)
1900 E SE LOOP 323
TYLER, TX 75701
Smith County (903) 597-8081

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 1386088078. It was assigned to this organization in the NPPES registry on April 24, 2013. The provider is doing business as Walmart Pharmacy 10-4193.

Where is Wal-Mart Stores Texas LLC located?

Wal-Mart Stores Texas LLC is located at 1900 E SE Loop 323, Tyler, TX 75701. The listed phone number is (903) 508-6127.

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.

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 55 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 9, 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.