H-E-B, LP

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

21071 Issued in TX

Legal business name

H-E-B, LP

Doing business as

HEB Pharmacy #052

Practice address

3301 Sherwood Way
San Angelo, TX 76901

Phone

(325) 942-0454

Fax

(325) 949-9210

NPI assigned

Aug 30, 2006

Last updated

Sep 24, 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 #052 Doing business as

Medicare fee-for-service enrollment

Enrolled in TX2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare medical equipment & supply locations

Practitioners 17

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
• Bryndan Cruz Arredondo, PHARMD

  • Pharmacist
  • San Angelo, TX
  • NPI 1144913302
  NPD (past)
• Anthony Bray, PHARMD, RPH

  • Pharmacist
  • San Angelo, TX
  • NPI 1578088472
  NPD (past)
• Kimberly Cruz

  • Pharmacy Technician
  • San Angelo, TX
  • NPI 1740142298
  NPD (past)
• Sherry Lynne Deanda, RPH

  • Pharmacist
  • San Angelo, TX
  • NPI 1205149911
  NPD (past)
• Joseph Cole Dougan, RPH

  • Pharmacist
  • San Angelo, TX
  • NPI 1427588193
  NPD (past)
• Hunter Hernandez

  • Pharmacy Technician
  • San Angelo, TX
  • NPI 1619847878
  NPD (past)
• Misty Hinson

  • Pharmacy Technician
  • San Angelo, TX
  • NPI 1407445489
  NPD (past)
• Leslie Hung, RPH

  • Pharmacist
  • San Angelo, TX
  • NPI 1700301694
  NPD (past)
• Esmeralda Lara

  • Pharmacy Technician
  • San Angelo, TX
  • NPI 1649860982
  NPD (past)
• Destiny Renee Manley

  • Pharmacy Technician
  • San Angelo, TX
  • NPI 1598346397
  NPD (past)
• Olatubosun Olowolayemo

  • Pharmacy Technician
  • San Angelo, TX
  • NPI 1447831227
  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": "1600905600000",
    "number": "1285743625",
    "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": "3301 SHERWOOD WAY",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "76901",
            "telephone_number": "325-942-0454",
            "fax_number": "325-949-9210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "H-E-B, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-09-24",
        "certification_date": "2020-09-24",
        "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": "21071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "470082",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "4583426",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HEB Pharmacy #052",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Luz Enix Guthrie, LPC
• Christian Gutierrez, MD
• Ivy Lynn Gutierrez
• Gideon Kwame Siaw Gyampoh, MD
• H-E-B, LP (HEB Pharmacy #734)
• Sandy Haby, CHWI, CHW
• Theodore E Hackl
• Christopher A Haddad, M.D.
• Rudy M Haddad, M.D.
• Lance Eliot Hafter, D.O.

• Community/Retail Pharmacy in San Angelo, TX
• Providers in San Angelo, 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 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.