MEDICARE: WAL-MART STORES TEXAS, LLC

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	:	1750484713
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WAL-MART STORES TEXAS, LLC

Provider Business Mailing Address
First Line	:	702 SW 8TH ST
Second Line	:
City	:	BENTONVILLE
State	:	AR
Zip	:	72716-0445
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3302 SE MILITARY DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78223-3980
Country	:	US
Telephone Number	:	210-337-4562
Fax Number	:

Authorized Official
Title or Position	:	MANAGER, GOV'T CONTRACTING
Name	:	LAURA LEVINE
Credential	:
Telephone Number	:	479-204-8550

Provider Enumeration Date	:	09/06/2006
Last Update Date	:	06/06/2013

Similar Medicare Providers

1881914000 — GRUPO MEDICO POLICLINICA SAN PEDRO MEDICARE ADVANTAGE
Practice Location Address:

211 CALLE MORSE
ARROYO, PR
00714-2350

Practice Phone: 787-839-3980
Practice Fax: 787-271-2515

1932126166 — WAL-MART STORES TEXAS LLC
Practice Location Address:

3302 SE MILITARY DR
SAN ANTONIO, TX
78223-3980

Practice Phone: 210-337-4434
Practice Fax:

1053588921 — DR. GRACIELA MARIALUISA SABLE O.D.
Practice Location Address:

3302 SE MILITARY DR
SAN ANTONIO, TX
78223-3980

Practice Phone: 210-858-9249
Practice Fax:

1104076900 — EXCELLENT EYE CARE
Practice Location Address:

3302 SE MILITARY DR
SAN ANTONIO, TX
78223-3980

Practice Phone: 210-858-9249
Practice Fax: 210-858-5759

1801833314 — JOEL RUSSEL MAUST M.D.
Practice Location Address:

3310 OAKWELL CT APT 16304
SAN ANTONIO, TX
78218-3980

Practice Phone: 214-282-6594
Practice Fax:

1053532606 — DR. BRADLEY JAY PIERSON DDS
Practice Location Address:

8358 N LOOP 1604 W STE 101
SAN ANTONIO, TX
78249-3980

Practice Phone: 210-695-1116
Practice Fax: 210-695-1108

Directions to “WAL-MART STORES TEXAS, LLC ” 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.