NPIMap

Organization Active NPI

H-E-B, LP

  • Community/Retail Pharmacy
  • Georgetown, TX
National Provider Identifier
1679682017
Registry record updated Jun 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
21118 Issued in TX
Legal business name
H-E-B, LP
Practice address
1010 W University Ave
Georgetown, TX 78626
Phone
(512) 869-4287
Fax
(512) 930-9777
NPI assigned
Aug 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2023

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

Authorized official

Name
Rodolfo Renteria
Title
Third Party Claims Analyst II
Phone
(210) 938-8361

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 21118 TX Primary

Addresses

Primary practice location

1010 W University Ave
Georgetown, TX 78626

Mailing address

646 South Flores
San Antonio, TX 78204

Other identifiers 2

IdentifierTypeStateIssuer
469067MedicaidTX
4579162OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • HEB Pharmacy #781 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20081216000621 TX Part B Supplier - Mass Immunization (Roster Biller Only) 8224190871 This NPI is an additional NPI on the enrollment
O20100930099631 TX DME Supplier - PharmacyDME Supplier - Grocery Store 8224190871 Practice locations: Georgetown, TX

National Provider Directory

National Provider Directory

Locations

1101 S Interstate 35
Georgetown, TX 78626
Phone (512) 869-2071

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687219200000",
    "number": "1679682017",
    "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": "1010 W UNIVERSITY AVE",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "78626",
            "telephone_number": "512-869-4287",
            "fax_number": "512-930-9777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "H-E-B, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-07",
        "status": "A",
        "authorized_official_last_name": "RENTERIA",
        "authorized_official_first_name": "RODOLFO",
        "authorized_official_title_or_position": "THIRD PARTY CLAIMS ANALYST II",
        "authorized_official_telephone_number": "210-938-8361"
    },
    "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": "21118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "469067",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "4579162",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HEB Pharmacy #781",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "HEB Pharmacy #781",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Georgetown, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2023; 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.