1. Home
  2. Directory
  3. Texas
  4. Celina
  5. Pharmacy
  6. NPI Profile

WAL-MART STORES TEXAS, LLC
NPI 1396603916
Pharmacy in Celina, TX

Active since January 13, 2026CLIA 45D2335334 · Waiver
400 ICY TRL, CELINA, TX 75009(972) 382-0133(972) 382-0135 Get Directions Write a Review

NPPES record last updated: January 13, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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 1396603916), doing business as Walmart Pharmacy 10-1250, is a healthcare organization registered as a pharmacy in Celina, Texas and active in the NPI registry since January 2026. The organization holds a CLIA Waiver certificate valid through December 8, 2027 and lists Kimberly Canonic, Senior Director, as its authorized official.

NPPES Registry Identity

NPI1396603916
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameWAL-MART STORES TEXAS, LLC
Location Address400 ICY TRLCelina, TX 75009-5780
Mailing Address1 Customer Dr, Mail Stop 0445Bentonville, AR 72716-0445
Phone(972) 382-0133
Fax(972) 382-0135
Organization SubpartNo
Authorized OfficialKimberly CanonicSenior Director · (480) 853-0515
Enumeration DateJanuary 13, 2026
NPPES CertifiedJanuary 13, 2026
✔ NPI 1396603916 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
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
400 ICY TRL, Celina, TX 75009
Open in Google Maps ↗

Other Names 1

Doing Business AsWalmart Pharmacy 10-1250

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D2335334

Wal-Mart Stores Texas, LLC Dba Walmart Pharmacy 10-1250 · Celina, TX
Active · expires Dec 8, 2027
CLIA Number45D2335334
Laboratory TypePharmacy
Certificate Effective DateDecember 9, 2025
Certificate Expiration DateDecember 8, 2027
Laboratory DirectorMary Farag Ghobrial
Laboratory Phone(479) 371-2991
Laboratory LocationWal-Mart Stores Texas, LLC Dba Walmart Pharmacy 10-1250400 Icy Trl, Celina, TX 75009
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

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

MONOCLE EYECARE
Optometrist
400 ICY TRL
CELINA, TX 75009
Collin County (682) 287-7073
WAL-MART STORES TEXAS, LLC
Eyewear Supplier
400 ICY TRL
CELINA, TX 75009
Collin County (972) 382-0148

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 1396603916. It was assigned to this organization in the NPPES registry on January 13, 2026. The provider is doing business as Walmart Pharmacy 10-1250.

Where is Wal-Mart Stores Texas, LLC located?

Wal-Mart Stores Texas, LLC is located at 400 Icy Trl, Celina, TX 75009. The listed phone number is (972) 382-0133.

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

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

Does Wal-Mart Stores Texas, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D2335334) is associated with this NPI, valid through December 8, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Wal-Mart Stores Texas, LLC was last updated on January 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.