WAL-MART STORES TEXAS LLC - NPI 1770501470 - Pharmacy in Montgomery, TX

Q: What is the provider's specialty?

The provider's specialty is Pharmacy with taxonomy code 3336C0003X and a focus in Community/Retail Pharmacy.

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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 1770501470), doing business as Walmart Pharmacy 10-3591, is a healthcare organization registered as a community/retail pharmacy in Montgomery, 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

NPI1770501470

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business NameWAL-MART STORES TEXAS LLC

Location Address18700 HIGHWAY 105 WMontgomery, TX 77356-5625

Mailing Address702 Sw 8th StBentonville, AR 72716-0445 · (479) 277-1242 · Fax (479) 277-4331

Phone(936) 582-1005

Organization SubpartNo

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

Enumeration DateJuly 18, 2006

Last NPPES UpdateJuly 2, 20253 updates tracked since enumeration

NPPES CertifiedJuly 2, 2025

✔ NPI 1770501470 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 · 22577

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

18700 HIGHWAY 105 W, Montgomery, TX 77356

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Other Names 1

Doing Business AsWalmart Pharmacy 10-3591

Other Identifiers 2

Medicaid469649TX

Other2098574Pk

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 2024 & 2026 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.

198 services194 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.

192 services188 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.

41 services41 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.

41 services41 patients

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.

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