H-E-B, LP

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

22551 Issued in TX

Legal business name

H-E-B, LP

Doing business as

HEB Pharmacy #589

Practice address

4800 Hwy 365
Port Arthur, TX 77642

Phone

(409) 722-4066

Fax

(409) 722-4588

NPI assigned

Aug 30, 2006

Last updated

Sep 23, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

David LiendoNPI 1376857813

Title

Government Programs Manager

Phone

(210) 938-3182

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• HEB Pharmacy #589 Doing business as

Medicare fee-for-service enrollment

Enrolled in TX2 enrollments

Enrollment records 2

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David Liendo

  • Pharmacy Technician
  • San Antonio, TX
  • NPI 1376857813
  Authorized official Same address or phone
• Aida Janet Gutierrez, CPHT

  • Pharmacy Technician
  • Port Arthur, TX
  • NPI 1225627607
  NPD (past)
• Jason W King, RPH

  • Pharmacist
  • Port Arthur, TX
  • NPI 1992037139
  NPD (past)
• Anna Li

  • Pharmacist
  • Port Arthur, TX
  • NPI 1821744822
  NPD (past)
• Gary Jonathan Self, RPH

  • Pharmacist
  • Port Arthur, TX
  • NPI 1811228265
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600819200000",
    "number": "1063521490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "646 SOUTH FLORES",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 HWY 365",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "77642",
            "telephone_number": "409-722-4066",
            "fax_number": "409-722-4588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "H-E-B, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-09-23",
        "certification_date": "2020-09-23",
        "status": "A",
        "authorized_official_last_name": "LIENDO",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "GOVERNMENT PROGRAMS MANAGER",
        "authorized_official_telephone_number": "210-938-3182"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "22551",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "469192",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "4528622",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HEB Pharmacy #589",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gulf Coast Health Center, Inc. (Gulf Coast Health Center-Phillis Wheatley-SBHC)
• Gulf Coast Open MRI Unit LTD
• Gulfside Dental Port Arthur PLLC
• Aida Janet Gutierrez, CPHT
• Maria E Gutierrez, M.ED., LPC
• Kahirup Calimlin Habana, PT
• Desalegn Hailu
• Chris Hale, CST, SA-C
• Doris Renee Hale, M.S., CCC-SLP
• Colin Leonard Hales, MD

• Community/Retail Pharmacy in Port Arthur, TX
• Providers in Port Arthur, TX by specialty
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.