Heb # 451

NPI #1194066936 in Austin, Texas

Provider Information

NPI Number: 1194066936
Entity Type: Organization
Organization Name: Heb # 451
Primary Specialty: Pharmacist
Enumeration Date: Mar 4, 2013
Last Updated: Mar 4, 2013

Practice Location

Address: 7301 N FM 620
City: Austin
State: Texas
ZIP Code: 78726-4539
Phone: (512) 336-7706

Authorized Official

Name: MR. LARRY ROBERT BOENIG, RPH
Title: STAFF PHARMACIST
Phone: (512) 336-7706

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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