Healthcare Provider Details

I. General information

NPI: 1053285692
Provider Name (Legal Business Name): TXRX LLC DBA FIESTARX
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 PALO ALTO RD STE 240
SAN ANTONIO TX
78211-3758
US

IV. Provider business mailing address

102 PALO ALTO RD STE 240
SAN ANTONIO TX
78211-3758
US

V. Phone/Fax

Practice location:
  • Phone: 210-201-4517
  • Fax: 210-281-4026
Mailing address:
  • Phone: 210-201-4517
  • Fax: 210-281-4026

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JODY R WELCHANS
Title or Position: GENERAL MANAGER
Credential: RPH
Phone: 210-227-7207