Organization Active NPI

Lifecare Pharmacy Barlite

  • Community/Retail Pharmacy
  • San Antonio, TX
National Provider Identifier
1396297198
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
31264 Issued in TX
Legal business name
LIFECARE PHARMACY BARLITE
Practice address
7355 Barlite Blvd Ste 101B
San Antonio, TX 78224-1340
Phone
(210) 817-4231
Fax
(210) 817-4232
NPI assigned
Oct 27, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Prem Kalidindi
Title
Board Member
Phone
(917) 769-8014

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 31264 TX Primary

Addresses

Primary practice location

7355 Barlite Blvd Ste 101B
San Antonio, TX 78224-1340

Mailing address

PO Box 12929
San Antonio, TX 78212-0929
Phone (210) 881-0890

Other identifiers 2

IdentifierTypeStateIssuer
149593MedicaidTX
2164649OtherPK

Other names 1

  • Fiesta Lifecare Pharmacy 2 LLC Doing business as

National Provider Directory

National Provider Directory

Locations

7355 Barlite Blvd
Ste 101B
San Antonio, TX 78224
Phone (210) 817-4231

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1477526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758240000000",
    "number": "1396297198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12929",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782120929",
            "telephone_number": "210-881-0890",
            "fax_number": "210-569-6464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7355 BARLITE BLVD STE 101B",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782241340",
            "telephone_number": "210-817-4231",
            "fax_number": "210-817-4232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFECARE PHARMACY BARLITE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-27",
        "last_updated": "2025-09-19",
        "status": "A",
        "authorized_official_last_name": "KALIDINDI",
        "authorized_official_first_name": "PREM",
        "authorized_official_title_or_position": "BOARD MEMBER",
        "authorized_official_telephone_number": "917-769-8014"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "31264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149593",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2164649",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fiesta Lifecare Pharmacy 2 LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fiesta Lifecare Pharmacy 2 LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.