Super Drug Mart Inc
Super Drug Mart Inc is a healthcare organization registered as Pharmacist in Lytle, TX, holding Type 2 (organization) NPI 1679623482 since 2007. The authorized official on file is Raymond Ibanez, Owner/Pharmacist.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1679623482 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Super Drug Mart Inc |
| Other name | <Unavail> |
| Practice address | 19010 PRIEST BLVD, Lytle, TX, 78052 |
| Phone | 8307090360 |
| Fax | 8307090363 |
| Enumeration date | 2007-01-12 |
| Last updated in NPPES | 2015-05-19 |
Authorized official
| Name | Raymond Ibanez |
|---|---|
| Title | Owner/Pharmacist |
| Phone | 2108842543 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 183500000X | Pharmacist | Primary | 20307 | TX |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20307 | Other | TX | STATE BOARD OF PHARMACY |
| 144974 | Medicaid | TX | — |
Copy-ready billing details
Provider: Super Drug Mart Inc NPI: 1679623482 Taxonomy: 183500000X (Pharmacist) Address: 19010 PRIEST BLVD, Lytle, TX, 78052
Verify this record
Cross-check NPI 1679623482 against the authoritative CMS record: view Super Drug Mart Inc on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
Where is Super Drug Mart Inc located?
How current is this record?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2015-05-19.