Provider Demographics
NPI:1689788671
Name:DENNIS W HELBERT
Entity Type:Organization
Organization Name:DENNIS W HELBERT
Other - Org Name:LIVE OAK PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:W
Authorized Official - Last Name:HELBERT
Authorized Official - Suffix:
Authorized Official - Credentials:DPH, RPH
Authorized Official - Phone:325-643-2648
Mailing Address - Street 1:3707 AUSTIN AVE
Mailing Address - Street 2:
Mailing Address - City:BROWNWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76801-6626
Mailing Address - Country:US
Mailing Address - Phone:325-643-2648
Mailing Address - Fax:325-646-4103
Practice Address - Street 1:3707 AUSTIN AVE
Practice Address - Street 2:
Practice Address - City:BROWNWOOD
Practice Address - State:TX
Practice Address - Zip Code:76801-6626
Practice Address - Country:US
Practice Address - Phone:325-643-2648
Practice Address - Fax:325-646-4103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX144953336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4583717OtherNCPDP PROVIDER IDENTIFICATION NUMBER
TX143717Medicaid