Organization
H-E-B, LP
Active
Other names
HEB PHARMACY #631
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID LIENDO (GOVERNMENT PROGRAMS MANAGER)
(210) 938-3182
Entity
Organization
Contact information
Practice address
3804 EAST US HIGHWAY 377, GRANBURY, TX 76049
(817) 579-2512
(817) 579-2516
Mailing address
646 S MAIN FLORES, SAN ANTONIO, TX 78204
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27519
TSBP
TX
05
—
469087
—
TX
Enumeration date
06/13/2011
Last updated
09/24/2020
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