H-E-B, LP

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

H-E-B, LP

Doing business as

HEB Pharmacy #692

Practice address

3590 College Street
Beaumont, TX 77701

Phone

(409) 813-8452

Fax

(409) 980-5883

NPI assigned

Mar 30, 2015

Last updated

Sep 25, 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 2

Addresses

Other identifiers 4

Other names 1

• HEB Pharmacy #692 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 7

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
• Ebony N Alfred

  • Pharmacy Technician
  • Beaumont, TX
  • NPI 1821687294
  NPD (past)
• Yeimmi Arriaga

  • Pharmacy Technician
  • Beaumont, TX
  • NPI 1508455999
  NPD (past)
• Rhonda R. Babino, PHARMD

  • Pharmacist
  • Beaumont, TX
  • NPI 1619280922
  NPD (past)
• Michaela Rae Dozhier

  • Pharmacist
  • Beaumont, TX
  • NPI 1558950758
  NPD (past)
• Muhib Mohammad, PHARMD

  • Community/Retail Pharmacy
  • Beaumont, TX
  • NPI 1427689058
  NPD (past)
• Sheila Vidal, RPH

  • Pharmacist
  • Beaumont, TX
  • NPI 1356761167
  NPD (past)

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

{
    "created_epoch": "1427673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600992000000",
    "number": "1831584663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "646 SOUTH FLORES STREET",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78204",
            "telephone_number": "210-938-3182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3590 COLLEGE STREET",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "77701",
            "telephone_number": "409-813-8452",
            "fax_number": "409-980-5883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "H-E-B, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-30",
        "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": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS MEDICAID",
            "identifier": "467134",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "5915105",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS STATE BOARD OF PHARMACY",
            "identifier": "29808",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "469050",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HEB Pharmacy #692",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "HEB Pharmacy #692",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mehmet Gurgun, M.D.
• Charles John Gutierrez, M.D.
• Catherine Elaine Guyote, FNP
• Gwendolyn L. Lavalais, M.D., P.a.
• H-E-B, LP (HEB Pharmacy #048)
• Thong Minh Ha
• Ashley Haas-Koelker, PA
• Taha Abdou Kamal Abdou Sa Habila, M.D.
• Allyssa J Hagan
• Varan Haghshenas, M.D.

• Community/Retail Pharmacy in Beaumont, TX
• Providers in Beaumont, 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 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.