Active NPI
Amber Taylor Benavides, PA
- Family Medicine Physician
- Laredo, TX
National Provider Identifier
1104592005
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- PA13628
- Practice address
- 3527 Jaime Zapata Memorial Hwy Ste 101
Laredo, TX 78043-4788 - Phone
- (956) 711-5007
- NPI assigned
- Aug 19, 2021
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | PA13628 | TX | Primary |
Addresses
Primary practice location
3527 Jaime Zapata Memorial Hwy Ste 101
Laredo, TX 78043-4788
Mailing address
3527 Jaime Zapata Memorial Hwy Ste 101
Laredo, TX 78043-4788
Phone (956) 711-5007
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA13628 | TX | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629331200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629331200000",
"number": "1104592005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3527 JAIME ZAPATA MEMORIAL HWY STE 101",
"city": "LAREDO",
"state": "TX",
"postal_code": "780434788",
"telephone_number": "956-711-5007"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3527 JAIME ZAPATA MEMORIAL HWY STE 101",
"city": "LAREDO",
"state": "TX",
"postal_code": "780434788",
"telephone_number": "956-711-5007"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENAVIDES",
"first_name": "AMBER",
"middle_name": "TAYLOR",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-08-19",
"last_updated": "2021-08-19",
"certification_date": "2021-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "PA13628",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Laredo, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.