HEB PHARMACY #631 – Community/Retail Pharmacy, NPI 1417242926

HEB PHARMACY #631 is a healthcare provider. based in Granbury, Texas. specializing in Community/Retail Pharmacy. The NPI Number for HEB PHARMACY #631 is 1417242926

Main info

Organization
Name
HEB PHARMACY #631
NPI
1417242926
Phone
(817) 579-2512
Address
3804 EAST US HIGHWAY 377
Authorized Official
DAVID LIENDO GOVERNMENT PROGRAMS MANAGER
Enumeration Date
13 June 2011
Last Update Date
24 September 2020
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness80
Years active:14State licenses:0Digital endpointsUpdated within 12 months

Provider Addresses for HEB PHARMACY #631

  • 3804 EAST US HIGHWAY 377

    GRANBURY, TX 76049

    Phone: (817) 579-2512

    Fax: (817) 579-2516

    Type: Location

  • 646 S MAIN FLORES

    SAN ANTONIO, TX 78204

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2012-09-06

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2025-12-31 (163 days ago).

Enrollment records

1

Earliest due date

2025-12-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20120906000867OPharmacyTX2025-12-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
G0008Administration of influenza virus vaccine735732$0
90662Influenza vaccine split virus, preservative free660660$0
90480Admn sarscov2 vacc 1 dose425424$0
91320Sarscv2 vac 30mcg trs-suc im233233$0
K1034Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count21647$0
View full utilization report →

Insurance plans in this area (ZIP 76049)

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Reviews

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Frequently asked questions

What is the 10-digit NPI for HEB PHARMACY #631?
HEB PHARMACY #631 — NPI 1417242926 — is the standard way to identify this listing.
Does CMS list HEB PHARMACY #631 as active?
Yes — HEB PHARMACY #631 is active in the NPI listing used on this page.
What is HEB PHARMACY #631 best known for clinically?
Directory data describes HEB PHARMACY #631 with Community/Retail Pharmacy. Clinical services aligned with this taxonomy classification.
Where should I expect HEB PHARMACY #631 on a map?
Expect Granbury, Texas as a primary anchor for HEB PHARMACY #631 unless the record lists multiple sites.
What does 'Organization' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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