Organization
H-E-B, LP
Active
Other names
HEB Pharmacy #754
Organization subpart
No
Provider details
NPI number
Authorized official
RODOLFO RENTERIA (THIRD PARTY CLAIMS ANALYST III)
(210) 938-8361
Entity
Organization
Contact information
Practice address
2400 S CONGRESS AVE, AUSTIN, TX 78704-5512
(512) 442-1578
(512) 444-4255
Mailing address
646 SOUTH FLORES, SAN ANTONIO, TX 78204
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
21069
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4559033
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
469095
—
TX
Enumeration date
08/30/2006
Last updated
12/02/2024
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