Active NPI
Mitchell Robert Lestico, PHARM.D.
- Pharmacotherapy Pharmacist
- Pflugerville, TX
National Provider Identifier
1104959386
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacotherapy Pharmacist
- License
- 34249
- Practice address
- 15822 Foothill Farms Loop
Pflugerville, TX 78660-3422 - Phone
- (512) 251-6096
- NPI assigned
- Mar 14, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacotherapy Pharmacist | 1835P1200X | 34249 | TX | Primary |
Addresses
Primary practice location
15822 Foothill Farms Loop
Pflugerville, TX 78660-3422
Mailing address
3328 Ranch Park TRL
Round Rock, TX 78681-2341
Phone (512) 255-2936
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34249 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104959386",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3328 RANCH PARK TRL",
"city": "ROUND ROCK",
"state": "TX",
"postal_code": "786812341",
"telephone_number": "512-255-2936"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15822 FOOTHILL FARMS LOOP",
"city": "PFLUGERVILLE",
"state": "TX",
"postal_code": "786603422",
"telephone_number": "512-251-6096"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LESTICO",
"first_name": "MITCHELL",
"middle_name": "ROBERT",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "TX",
"license": "34249",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pflugerville, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.