Provider Demographics
NPI:1457083248
Name:H-E-B LP
Entity Type:Organization
Organization Name:H-E-B LP
Other - Org Name:HEB PHARMACY #768
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR THIRD PARTY AFFAIRS
Authorized Official - Prefix:
Authorized Official - First Name:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:BUECHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-938-3182
Mailing Address - Street 1:646 S FLORES ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78204-1219
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2652 LAKE AUSTIN BLVD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78703
Practice Address - Country:US
Practice Address - Phone:210-938-2768
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-29
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No291U00000XLaboratoriesClinical Medical Laboratory