WAL-MART STORES TEXAS LLC
NPI 1609893866
Pharmacy - Community/Retail Pharmacy in Fredericksburg, TX

Active since July 16, 2006
1435 E MAIN ST, FREDERICKSBURG, TX 78624(830) 997-3047 Get Directions Write a Review

NPPES record last updated: June 5, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jun 5, 2025, Feb 15, 2017, Aug 26, 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 1609893866), doing business as Walmart Pharmacy 10-1154, is a healthcare organization registered as a community/retail pharmacy in Fredericksburg, Texas and active in the NPI registry since July 2006. The organization lists Kimberly Canonic, Senior Director, Enrollment, as its authorized official.

NPPES Registry Identity

NPI1609893866
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameWAL-MART STORES TEXAS LLC
Location Address1435 E MAIN STFredericksburg, TX 78624-5273
Mailing Address702 Sw 8th StBentonville, AR 72716-0445 · (479) 277-1238 · Fax (479) 277-4331
Organization SubpartNo
Authorized OfficialKimberly CanonicSenior Director, Enrollment · (480) 277-6348
Enumeration DateJuly 16, 2006
Last NPPES UpdateJune 5, 20253 updates tracked since enumeration
NPPES CertifiedJune 5, 2025
NPI 1609893866 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License Licensed in TX · 21840
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
Also ListedPharmacyTaxonomy 333600000X
1435 E MAIN ST, Fredericksburg, TX 78624

Other Names 1

Doing Business AsWalmart Pharmacy 10-1154

Other Identifiers 2

Other2097236Pk
Medicaid469739TX

Accepted 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.
429 services425 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.
408 services406 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.
71 services71 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.
63 services63 patients

Medical Equipment Supplier Medicare DMEPOS 11

Medicare supplier enrollment and the product categories Walmart Pharmacy 10-1154 carries, from the Medicare DMEPOS supplier directory.

Walmart Pharmacy 10-1154

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

Does not accept Medicare assignment

Walmart Pharmacy 10-1154 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)20609327
Medicare Participant SinceNovember 29, 2001
Supplier Location1435 E Main StFredericksburg, TX 78624
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
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
Blood Glucose Monitors/Supplies (Non-Mail Order)
Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device
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 2

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

Pharmacist
1435 E MAIN ST
FREDERICKSBURG, TX 78624
Eyewear Supplier
1435 E MAIN ST
FREDERICKSBURG, TX 78624

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 1609893866. It was assigned to this organization in the NPPES registry on July 16, 2006.

Where is Wal-Mart Stores Texas LLC located?

Wal-Mart Stores Texas LLC is located at 1435 E Main St, Fredericksburg, TX 78624. The listed phone number is (830) 997-3047.

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.

Does Wal-Mart Stores Texas LLC accept Medicare assignment for medical equipment?

No. As a Medicare medical equipment supplier, Walmart Pharmacy 10-1154 does not accept Medicare assignment for equipment and supplies, so patients may be charged more than the Medicare-approved amount. Confirm the expected cost with the supplier before ordering.

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 5, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.