MEDICARE: WAL-MART STORES TEXAS, LP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	156FX1800X	Optician
2	332H00000X	Eyewear Supplier

General Provider Information

NPI Number	:	1356422737
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WAL-MART STORES TEXAS, LP

Provider Business Mailing Address
First Line	:	702 SW 8TH STREET
Second Line	:
City	:	BENTONVILLE
State	:	AR
Zip	:	72716-0235
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1311 S JACKSON ST
Second Line	:
City	:	JACKSONVILLE
State	:	TX
Zip	:	75766-3050
Country	:	US
Telephone Number	:	903-589-3434
Fax Number	:

Authorized Official
Title or Position	:	NPI COORDINATOR
Name	:	LINDA M. EPPERSON
Credential	:
Telephone Number	:	316-788-5580

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	05/05/2025

Similar Medicare Providers

1043153554 — AMANDA MURPHY
Practice Location Address:

1311 S JACKSON ST
JACKSONVILLE, TX
75766-3050

Practice Phone: 903-589-3714
Practice Fax: 903-541-2165

1447277611 — WAL-MART STORES TEXAS LLC
Practice Location Address:

1311 S JACKSON ST
JACKSONVILLE, TX
75766-3050

Practice Phone: 903-586-1164
Practice Fax:

1114028289 — DR. RAYMOND D BOONE O.D.
Practice Location Address:

1311 S JACKSON ST , SUITE A
JACKSONVILLE, TX
75766-3050

Practice Phone: 903-586-1514
Practice Fax: 903-586-1515

1699210799 — DENTAL ZONE PLLC
Practice Location Address:

1311 S JACKSON ST , SUITE G
JACKSONVILLE, TX
75766-3050

Practice Phone: 617-838-2696
Practice Fax:

1295336576 — LAUREN LEE PHARM D
Practice Location Address:

1311 S JACKSON ST
JACKSONVILLE, TX
75766-3050

Practice Phone: 903-586-1164
Practice Fax:

1780359802 — OLUWASEGUN OYENPEMI PHARMD
Practice Location Address:

1311 S JACKSON ST
JACKSONVILLE, TX
75766-3050

Practice Phone: 903-589-3434
Practice Fax:

Directions to “WAL-MART STORES TEXAS, LP ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.