WAL-MART STORES TEXAS, LLC
NPI: 1306259205
· SACHSE, TX 75048
· Optician
· NPI assigned 06/09/2014
$331.00
Total Medicaid Paid
Provider Details
| Authorized Official | LEVINE, LAURA (DIR HEATHCARE CONT & ENROLLMENT) |
| Parent Organization | WAL-MART STORES, INC |
| NPI Enumeration Date | 06/09/2014 |
Related Entities
Other providers sharing the same authorized official: LEVINE, LAURA
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2022 |
29 |
$331.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
29 |
26 |
$331.00 |