Healthcare Provider Details
I. General information
NPI: 1992030894
Provider Name (Legal Business Name): H-E-B, LP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/09/2009
Last Update Date: 09/25/2020
Certification Date: 09/25/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2121 FM 2920 RD
SPRING TX
77388
US
IV. Provider business mailing address
2121 FM 2920 RD
SPRING TX
77388-3412
US
V. Phone/Fax
- Phone: 281-907-7950
- Fax: 281-528-9615
- Phone: 281-907-7950
- Fax: 281-528-9615
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | FH1672573 |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | 26633 |
| License Number State | TX |
VIII. Authorized Official
Name:
DAVID
LIENDO
Title or Position: GOVERNMENT PROGRAMS MANAGER
Credential:
Phone: 210-938-3182