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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

FIESTA LIFECARE PHARMACY 5 LLC
NPI 1104377332
Pharmacy - Community/Retail Pharmacy in Houston, TX

Active since October 24, 2016CLIA 45D2209723 · Waiver
7900 FANNIN ST STE 1480, HOUSTON, TX 77054(915) 306-3222(915) 306-5222 Get Directions Write a Review

NPPES record last updated: July 26, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 26, 2026, Jul 30, 2020, Jul 19, 2018 and 2 more (5 updates tracked since 2016).

About Fiesta Lifecare Pharmacy 5 Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FIESTA LIFECARE PHARMACY 5 LLC (NPI 1104377332) is a healthcare organization registered as a community/retail pharmacy in Houston, Texas and active in the NPI registry since October 2016. The organization holds a CLIA Waiver certificate valid through January 14, 2027 and lists Sirisha Kandi, Pharmacist Owner, as its authorized official.

NPPES Registry Identity

NPI1104377332
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameFIESTA LIFECARE PHARMACY 5 LLC
Location Address7900 FANNIN ST STE 1480Houston, TX 77054-2946
Mailing Address968 Condor DrCoppell, TX 75019-5985 · (972) 357-4477 · Fax (214) 426-7586
Phone(915) 306-3222
Fax(915) 306-5222
Organization SubpartNo
Authorized OfficialSirisha KandiPharmacist Owner · (972) 357-4477
Enumeration DateOctober 24, 2016
Last NPPES UpdateJuly 26, 20265 updates tracked since enumeration
NPPES CertifiedJuly 26, 2026
✔ NPI 1104377332 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in TX · 31267
Definition
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 health care providers, collaborative practice, disease state management, and education classes.
Also ListedPharmacyTaxonomy 333600000X
7900 FANNIN ST STE 1480, Houston, TX 77054
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Other Names 2

Doing Business AsFiesta Lifecare Pharmacy 5 Llc
Doing Business AsFiesta Mlk Pharmacy

Other Identifiers 2

Other2164652Pk
Medicaid149805TX

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D2209723

Fiesta Lifecare Pharmacy 5, LLC · Dallas, TX
Active · expires Jan 14, 2027
CLIA Number45D2209723
Laboratory TypePharmacy
Certificate Effective DateJanuary 15, 2025
Certificate Expiration DateJanuary 14, 2027
Laboratory DirectorSirisha Kandi
Laboratory Phone(214) 421-1067
Laboratory LocationFiesta Lifecare Pharmacy 5, LLC3230 Martin Luther King Jr Blvd Pharmacy Dept, Dallas, TX 75210
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CUSTOM CARE RX LLC
Pharmacy (Community/Retail Pharmacy)
7900 FANNIN ST STE 1480
HOUSTON, TX 77054
Harris County (714) 717-7247

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fiesta Lifecare Pharmacy 5 LLC's NPI number?

The NPI number for Fiesta Lifecare Pharmacy 5 LLC is 1104377332. It was assigned to this organization in the NPPES registry on October 24, 2016. The provider is doing business as Fiesta MLK Pharmacy.

Where is Fiesta Lifecare Pharmacy 5 LLC located?

Fiesta Lifecare Pharmacy 5 LLC is located at 7900 Fannin St Ste 1480, Houston, TX 77054. The listed phone number is (915) 306-3222.

What is Fiesta Lifecare Pharmacy 5 LLC's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Does Fiesta Lifecare Pharmacy 5 LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D2209723) is associated with this NPI, valid through January 14, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Fiesta Lifecare Pharmacy 5 LLC accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 55 other insurers list Fiesta Lifecare Pharmacy 5 LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Fiesta Lifecare Pharmacy 5 LLC was last updated on July 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.