Organization
H-E-B, LP
Active
Other names
HEB PHARMACY #416
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID LIENDO (GOVERNMENT PROGRAMS MANAGER)
(210) 938-3182
Entity
Organization
Contact information
Practice address
450 E TRAVIS ST, LA GRANGE, TX 78945
(979) 968-8677
(979) 968-9625
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
21148
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4599253
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
469868
—
TX
Enumeration date
08/24/2006
Last updated
09/25/2020
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