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Organization

H-E-B, LP

Active
Other names
HEB Pharmacy #781
Organization subpart
No

Provider details

NPI number
Authorized official
RODOLFO RENTERIA (THIRD PARTY CLAIMS ANALYST II)
(210) 938-8361
Entity
Organization

Contact information

Practice address
1010 W UNIVERSITY AVE, GEORGETOWN, TX 78626
(512) 869-4287
(512) 930-9777
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
21118
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4579162
NCPDP PROVIDER IDENTIFICATION NUMBER
05
469067
TX
Enumeration date
08/30/2006
Last updated
06/20/2023
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