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Organization

H-E-B, LP

Active
Other names
HEB Pharmacy #641
Organization subpart
No

Provider details

NPI number
Authorized official
DAVID LIENDO (GOVERNMENT PROGRAMS MANAGER)
(210) 938-3182
Entity
Organization

Contact information

Practice address
1841 CHURCH ST., GONZALES, TX 78629
(830) 672-6590
(830) 672-6191
Mailing address
646 S FLORES ST, SAN ANTONIO, TX 78204-1219
(210) 938-3182

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
27810
STATE BOARD OF PHARMACY
TX
05
469276
TX
01
5905039
NCPDP
Enumeration date
01/06/2012
Last updated
09/25/2020
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