Organization
H-E-B, LP
Active
Other names
HEB Pharmacy #692
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID LIENDO (GOVERNMENT PROGRAMS MANAGER)
(210) 938-3182
Entity
Organization
Contact information
Practice address
3590 COLLEGE STREET, BEAUMONT, TX 77701
(409) 813-8452
(409) 980-5883
Mailing address
646 SOUTH FLORES STREET, SAN ANTONIO, TX 78204
(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
—
29808
TEXAS STATE BOARD OF PHARMACY
TX
01
—
467134
TEXAS MEDICAID
TX
05
—
469050
—
TX
01
—
5915105
NCPDP
TX
Enumeration date
03/30/2015
Last updated
09/25/2020
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