Organization · Type 2 NPI

Lifecare Pharmacy Medical Drive

Community/Retail Pharmacy · San Antonio, TX

NPI number 1669924569 Active

Practice location

4458 Medical Dr Ste 115
San Antonio, TX 78229-3700

Call (214) 351-0007 Map

Fax (214) 351-1750

Mailing address

PO Box 12929
San Antonio, TX 78212-0929

Specialties and licenses

Taxonomy	Code	License
Pharmacy	333600000X	None listed
Community/Retail Pharmacy Primary	3336C0003X	31269 (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 …

Other community/retail pharmacy providers in San Antonio

See all in San Antonio →

NPI record

NPI: 1669924569
Entity type: Organization (Type 2)
Issued: Oct 27, 2016
Last updated: Sep 19, 2025
Status: Active

Other names

<unavail>
Fiesta Lifecare Pharmacy 1 LLC · doing business as
Fiesta Lifecare Pharmacy 1 LLC · doing business as

Authorized official

Prem Kalidindi
Board Member
(917) 769-8014

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.

Is this your record? How to update it.

About NPI 1669924569

Lifecare Pharmacy Medical Drive's National Provider Identifier is 1669924569, issued on Oct 27, 2016. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in San Antonio, TX. The record was last updated on Sep 19, 2025.