Organization
FIESTA RX LLC
Active
Other names
Crawford Pharmacy, Fiesta Rx #5
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JODY WELCHANS RPH (GENERAL MANAGER)
(210) 385-8013
Entity
Organization
Contact information
Practice address
407 E ORANGE AVE, ORANGE GROVE, TX 78372
(361) 384-4077
(361) 384-4209
Mailing address
407 E ORANGE AVE, ORANGE GROVE, TX 78372
(361) 384-4077
(361) 384-4209
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33272
BOARD OF PHARMACY LICENSE
TX
Enumeration date
06/08/2020
Last updated
03/13/2026
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