Organization · Type 2 NPI

Fiesta Lifecare Pharmacy 5 LLC

Community/Retail Pharmacy · Houston, TX

NPI number 1104377332 Active

Practice location

7900 Fannin St Ste 1480
Houston, TX 77054-2946

Call (915) 306-3222 Map

Fax (915) 306-5222

Mailing address

968 Condor Dr
Coppell, TX 75019-5985

Specialties and licenses

Taxonomy	Code	License
Pharmacy	333600000X	None listed
Community/Retail Pharmacy Primary	3336C0003X	31267 (TX)

Community/Retail Pharmacy: A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other …

Another provider at this address

Custom Care RX LLCCommunity/Retail Pharmacy Houston, TX NPI 1215636485

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NPI record

NPI: 1104377332
Entity type: Organization (Type 2)
Issued: Oct 24, 2016
Last updated: Jul 26, 2026
Status: Active

Other names

<unavail>
Fiesta Lifecare Pharmacy 5 LLC · doing business as
Fiesta Lifecare Pharmacy 5 LLC · doing business as
Fiesta MLK Pharmacy · doing business as

Authorized official

Sirisha Kandi
Pharmacist Owner
(972) 357-4477

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1104377332

Fiesta Lifecare Pharmacy 5 LLC's National Provider Identifier is 1104377332, issued on Oct 24, 2016. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in Houston, TX. The record was last updated on Jul 26, 2026.