Provider Demographics
NPI:1427563006
Name:H-E-B, LP
Entity type:Organization
Organization Name:H-E-B, LP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:GOVERNMENT PROGRAMS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:LIENDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-938-3182
Mailing Address - Street 1:646 S FLORES ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78204-1219
Mailing Address - Country:US
Mailing Address - Phone:210-938-8000
Mailing Address - Fax:
Practice Address - Street 1:5251 FM 2920
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77388
Practice Address - Country:US
Practice Address - Phone:281-353-2982
Practice Address - Fax:281-323-6483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-05
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX471230Medicaid