Organization Active NPI

Oscar Benavides MD PA

  • Family Medicine Physician
  • Laredo, TX
National Provider Identifier
1225180946
Registry record updated Oct 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
H9039 Issued in TX
Legal business name
OSCAR BENAVIDES MD PA
Practice address
209 W Village Blvd Ste 11
Laredo, TX 78041-2227
Phone
(956) 725-5210
Fax
(956) 717-1708
NPI assigned
Jan 16, 2007
Last updated
Oct 17, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2019

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

Authorized official

Name
Mrs. Felicitas Benavides, RN
Title
Manager
Phone
(956) 725-5210

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X H9039 TX Primary
Durable Medical Equipment & Medical Supplies 332B00000X 0104598 TX

Addresses

Primary practice location

209 W Village Blvd Ste 11
Laredo, TX 78041-2227

Mailing address

209 W Village Blvd Ste 11
Laredo, TX 78041-2227
Phone (956) 725-5210

Other names 1

  • Prof Association Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040421000928 TX Part B Supplier - Clinic/Group Practice 8224024724 Receives reassigned benefits from 1 practitioner
Practice locations: Laredo, TX

National Provider Directory

National Provider Directory

Locations

209 W Village Blvd
Ste 11
Laredo, TX 78041
Phone (956) 725-5210

209 W Village Blvd
Ste 3
Laredo, TX 78041
Phone (210) 725-5210

209 W Village Blvd
Ste 4
Laredo, TX 78041
Phone (210) 225-0607

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571270400000",
    "number": "1225180946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 W VILLAGE BLVD STE 11",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780412227",
            "telephone_number": "956-725-5210",
            "fax_number": "956-717-1708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 W VILLAGE BLVD STE 11",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780412227",
            "telephone_number": "956-725-5210",
            "fax_number": "956-717-1708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OSCAR BENAVIDES MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2019-10-17",
        "status": "A",
        "authorized_official_last_name": "BENAVIDES",
        "authorized_official_first_name": "FELICITAS",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "956-725-5210",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "H9039",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "0104598",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prof Association",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Prof Association",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Oct 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.