H-E-B, LP

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

21148 Issued in TX

Legal business name

H-E-B, LP

Doing business as

HEB PHARMACY #416

Practice address

450 E Travis St
La Grange, TX 78945

Phone

(979) 968-8677

Fax

(979) 968-9625

NPI assigned

Aug 24, 2006

Organization subpart

No

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

Addresses

Other identifiers 2

Other names 1

• HEB PHARMACY #416 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

Locations

Practitioners 10

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

• Samantha Fleming

  • Pharmacy Technician
  • La Grange, TX
  • NPI 1235728684
  NPD (past)
• Angelia Kay Foreman

  • Pharmacy Technician
  • La Grange, TX
  • NPI 1528657970
  NPD (past)
• Carmen Maria Lukner, RPH

  • Pharmacist
  • La Grange, TX
  • NPI 1235470626
  NPD (past)
• Rachel Russo

  • Pharmacist
  • La Grange, TX
  • NPI 1689110926
  NPD (past)
• Reina Torres, CPHT

  • Pharmacy Technician
  • La Grange, TX
  • NPI 1356079982
  NPD (past)
• Thien Tran

  • Pharmacist
  • La Grange, TX
  • NPI 1982293338
  NPD (past)
• Shelby Ann Trlicek, PHARMD

  • Pharmacist
  • La Grange, TX
  • NPI 1124670815
  NPD (past)
• Travis Eugene Ulrich, PHARMD

  • Pharmacist
  • La Grange, TX
  • NPI 1891150470
  NPD (past)
• Geralyn Vasut, RPH

  • Pharmacist
  • La Grange, TX
  • NPI 1912225442
  NPD (past)
• Amber Waitschies

  • Pharmacy Technician
  • La Grange, TX
  • NPI 1275122780
  NPD (past)

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600992000000",
    "number": "1932216199",
    "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": "450 E TRAVIS ST",
            "city": "LA GRANGE",
            "state": "TX",
            "postal_code": "78945",
            "telephone_number": "979-968-8677",
            "fax_number": "979-968-9625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "H-E-B, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "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": "21148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "4599253",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "469868",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HEB PHARMACY #416",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "HEB PHARMACY #416",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Angelia Kay Foreman
• Fresh Smiles PLLC
• Fresh Smiles-la Grange PLLC
• Katherine Gross, LPC
• Robert K Guillory, DC
• Robert Henry Hamff, RPH
• Hansen Hands, LLC
• Lana Leigh Harrison
• Suzanne Carlton Hart, PH.D.
• Richard Hartin Jr., MD

• Community/Retail Pharmacy in La Grange, TX
• Providers in La Grange, 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.