Healthcare Provider Details

I. General information

NPI: 1053739367
Provider Name (Legal Business Name): H-E-B, LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2014
Last Update Date: 08/07/2023
Certification Date: 08/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

646 S FLORES ST
SAN ANTONIO TX
78204-1219
US

IV. Provider business mailing address

646 S FLORES ST
SAN ANTONIO TX
78204-1219
US

V. Phone/Fax

Practice location:
  • Phone: 855-481-1149
  • Fax: 855-710-7869
Mailing address:
  • Phone: 855-481-1149
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: DAVID LIENDO
Title or Position: GOVERNEMENT PROGRAMS MANAGER
Credential:
Phone: 210-938-3182