Organization
H-E-B, LP
Active
Other names
HEB Pharmacy #623
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID LIENDO (GOVERNMENT PROGRAMS MANAGER)
(210) 938-3182
Entity
Organization
Contact information
Practice address
9238 N LOOP 1604 W, SAN ANTONIO, TX 78249
(210) 682-3419
(210) 682-3947
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
21158
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4508959
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
469632
—
TX
Enumeration date
08/30/2006
Last updated
09/25/2020
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