NPIMap

Organization Active NPI

H-E-B, LP

  • Community/Retail Pharmacy
  • Midland, TX
National Provider Identifier
1700995156
Registry record updated Sep 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
21135 Issued in TX
Legal business name
H-E-B, LP
Practice address
3325 W Wadley Ave
Midland, TX 79707
Phone
(432) 697-1484
Fax
(432) 697-1489
NPI assigned
Aug 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2020

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

Authorized official

Name
David Liendo
Title
Government Programs Manager
Phone
(210) 938-3182

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 21135 TX Primary

Addresses

Primary practice location

3325 W Wadley Ave
Midland, TX 79707

Mailing address

646 South Flores
San Antonio, TX 78204

Other identifiers 2

IdentifierTypeStateIssuer
4598186OtherNCPDP PROVIDER IDENTIFICATION NUMBER
469199MedicaidTX

Other names 1

  • HEB Pharmacy #382 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
O20100930093986 TX DME Supplier - Pharmacy 8224190871 Practice locations: Midland, TX

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D1074596Heb Pharmacy No 382 LP3325 Wadley, Midland, TX 79707Certificate of waiverOct 1, 2027

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Heb Pharmacy #3823325 W Wadley Ave, Midland, TX 79707-5714(432) 697-1484 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order) Accepts assignmentParticipating since Dec 21, 2011

National Provider Directory

National Provider Directory

Locations

3325 W Wadley Ave
Midland, TX 79707
Phone (432) 697-1484

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

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": "1600992000000",
    "number": "1700995156",
    "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": "3325 W WADLEY AVE",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "79707",
            "telephone_number": "432-697-1484",
            "fax_number": "432-697-1489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "H-E-B, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-09-25",
        "certification_date": "2020-09-25",
        "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": "21135",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "4598186",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "469199",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HEB Pharmacy #382",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Midland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.