WAL-MART STORES TEXAS, LLC (NPI# 1619384690) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619384690 |
| Entity Type | Organization |
| Organization Name | WAL-MART STORES TEXAS, LLC |
| Other Organization Name | WALMART CARE CLINIC 10-1801 |
| Practice Address |
4801 S Cooper St Arlington TX 76017-5928 |
| Mailing Address |
702 Sw 8th St Bentonville AR 72716-0445 |
| Practice Telephone | 8175578706 |
| Practice Fax Number | 8175578740 |
| Mailing Telephone | 4792048550 |
| Enumeration Date | 2014-07-22 |
| Last Update Date | 2015-02-19 |
| Authorized Official Name | LAURA LEVINE (DIRECTOR OF HEALTHCARE CONTRACTING) |
| Authorized Official Telephone | 4792048550 |
| Is Organization Subpart | Y |
| Parent Organization Name | WAL-MART STORES, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | MEDICARE PTAN | 358654ZHTP | 01 |
| Other Name | Type Code |
|---|---|
| Walmart Care Clinic 10-1801 | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194216143 | Wal-mart Stores Texas, LLC | Durable Medical Equipment & Medical Supplies | 26824 Fm 1093, Richmond, TX 77406 | 2018-05-25 |
| 1528555463 | Wal-mart Stores Texas, LLC | Durable Medical Equipment & Medical Supplies | 7831 Paseo Del Norte Blvd, Ste A, El Paso, TX 79912 | 2018-04-17 |
| 1619470770 | Wal-mart Stores Texas, LLC | Durable Medical Equipment & Medical Supplies | 5336 Golden Triangle Blvd, Fort Worth, TX 76244-4406 | 2018-03-15 |
| 1275067977 | Wal-mart Stores Texas, LLC | Durable Medical Equipment & Medical Supplies | 1951 Military Parkway, Mesquite, TX 75149 | 2017-04-19 |
| 1225578529 | Wal-mart Stores Texas, LLC | Technician/Technologist | 22850 Morton Rach Rd, Katy, TX 77449 | 2017-03-06 |
| 1912445487 | Wal-mart Stores Texas, LLC | Technician/Technologist | 1151 Us Hwy 90 E, Castroville, TX 78009 | 2017-02-06 |
| 1992256325 | Wal-mart Stores Texas, LLC | Technician/Technologist | 25800 Kuykendahl Road, Tomball, TX 77375 | 2016-10-20 |
| 1699123893 | Wal-mart Stores Texas, LLC | Technician/Technologist | 510 Kitty Hawk Rd, Universal City, TX 78148-3961 | 2016-05-27 |
| 1578923868 | Wal-mart Stores Texas, LLC | Technician/Technologist | 3440 S. Bryant Blvd, San Angelo, TX 76903 | 2016-02-29 |
| 1144680539 | Wal-mart Stores Texas, LLC | Technician/Technologist | 2901 Riley Fuzzell Road, Spring, TX 77386 | 2016-02-29 |
| Street Address |
4801 S COOPER ST |
| City | ARLINGTON |
| State | TX |
| Zip Code | 76017-5928 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245257401 | Wal-mart Stores Texas LLC | Durable Medical Equipment & Medical Supplies | 4801 S Cooper St, Arlington, TX 76017-5928 | 2006-07-16 |
| 1316547987 | Kristy Robertson | Pharmacist | 4801 S Cooper St, Arlington, TX 76017-5928 | 2020-10-31 |
| 1831799352 | Paige Miller | Pharmacist | 4801 S Cooper St, Arlington, TX 76017-5928 | 2020-10-26 |
| 1265891253 | Robin Hughes | Optometrist | 4801 S Cooper St, Ste. 1801, Arlington, TX 76017-5928 | 2016-02-18 |
| 1154707560 | Demishe Fontenot | Nurse Practitioner | 4801 S Cooper St, Arlington, TX 76017-5928 | 2015-08-07 |
| 1346587680 | Georgena D Wiley | Registered Nurse | 4801 S Cooper St, Arlington, TX 76017-5928 | 2013-01-07 |
| 1407096985 | Sonie Family Eyecare Pllc | Clinic/Center | 4801 S Cooper St, Arlington, TX 76017-5928 | 2009-02-24 |
| 1295811453 | Wal-mart Stores Texas, Lp | Technician/Technologist | 4801 S Cooper St, Arlington, TX 76017-5928 | 2006-10-31 |
| 1437263647 | Evelyn Okah Ayidu-omo | Optometrist | 4801 S Cooper St, Arlington, TX 76017-5928 | 2006-08-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972149714 | Elite Vision Center | Optometrist | 5335 W. Sublett Road, Suite 600, Arlington, TX 76017 | 2019-11-26 |
| 1497390694 | Ijeoma Esther Osuji | Nurse Practitioner | 5307 Alta Vista Lane, Arlington, TX 76017 | 2019-11-12 |
| 1003385386 | Peace Within | Counselor | 5904 S. Cooper Ste. 104 - Pmb 162, Arlington, TX 76017 | 2018-11-16 |
| 1750883229 | Lumin Health Physician Group, Pa | Pain Medicine | 808 W Interstate 20 Suite 201, Arlington, TX 76017 | 2018-03-01 |
| 1215438643 | Clover Francis | Licensed Vocational Nurse | 5211 Saratoga Lane, Arlington, TX 76017 | 2018-02-21 |
| 1265942593 | Maria Luisa Gonzalez | Community Health Worker | 5916 Wind Drift Trail, Arllington, TX 76017 | 2017-09-29 |
| 1285150318 | Divya Patel | Counselor | 5201 Windy Meadow Drive, Arlington, TX 76017 | 2017-08-21 |
| 1912420217 | Natalia Sampaio Goodwin | Registered Nurse | 811 W. Interstate 20, Suite 212, Arlington, TX 76017 | 2017-07-19 |
| 1962939744 | Sean Christopher Hembree | Chiropractor | 4304 Sw Green Oaks Blvd Ste 150, Arlington, TX 76017 | 2017-05-11 |
| 1154866119 | Deborah Tuckey Nystrom | Physical Therapist | 2310 West I-20, Suite 204, Arlington, TX 76017 | 2016-12-30 |
| Find all providers in zip 76017 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467066795 | Colleen Marie Gleason | Nurse Practitioner | 2522 S Arlington Mill Dr Apt D, Arlington, VA 22206-4033 | 2020-09-03 |
| 1013526466 | Deborah Anne Tenenbaum | Nurse Practitioner | 4000 Wilson Blvd Apt 1109, Arlington, VA 22203-4410 | 2020-07-30 |
| 1427519396 | Fatoumata Jallow | Nurse Practitioner | 2304 Cromwell Dr, Arlington, TX 76018-2560 | 2019-03-25 |
| 1730647991 | Victoria Agudah | Nurse Practitioner | 4621 S Cooper St Ste 131-657, Arlington, TX 76017-5866 | 2019-03-06 |
| 1124583679 | Mary Thi Huynh | Nurse Practitioner | 3600 Matlock Rd Ste 100, Arlington, TX 76015-3679 | 2019-02-08 |
| 1467917435 | Bratton Healthcare Enterprises Pllc | Nurse Practitioner | 7912 Joshua Tree Ct, Arlington, TX 76002-4767 | 2019-02-04 |
| 1548732316 | Megan Francis | Nurse Practitioner | 1010 N Glebe Rd Ste 100, Arlington, VA 22201-5795 | 2018-12-18 |
| 1417424219 | Tracy Julien | Nurse Practitioner | 801 E Abram St Ste 208, Arlington, TX 76010-1200 | 2018-10-30 |
| 1083190359 | Nicole Leigh Charles | Nurse Practitioner | 6511 Steck Cv, Arlington, TN 38002-4806 | 2018-07-19 |
| 1902398035 | Paul Ooyi | Nurse Practitioner | 1127 Autumn Mist Way, Arlington, TX 76005 | 2018-06-05 |
| Find all providers in ARLINGTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.