Individual provider Active NPI

Enrique F Benavides III, MD

  • Obstetrics & Gynecology Physician
  • Laredo, TX
National Provider Identifier
1972504181
Registry record updated Jun 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
K9224 Issued in TX
Practice address
1020 E Hillside Rd
Laredo, TX 78041-3287
Phone
(956) 727-7303
Fax
(956) 726-1224
NPI assigned
Aug 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X K9224 TX Primary

Addresses

Primary practice location

1020 E Hillside Rd
Laredo, TX 78041-3287

Mailing address

1020 E Hillside Rd
Laredo, TX 78041-3287
Phone (956) 727-7303

Other identifiers 1

IdentifierTypeStateIssuer
100796503MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050610000601 TX Practitioner - Obstetrics/Gynecology 1850335886 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Texas Medical Branch at Galveston, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Laredo Womens Center, P.a.Group PAC ID 9830133867, 3 clinicians

Practice addresses (Care Compare)

1020 E Hillside Rd
Laredo, TX 78041-3287
Phone (956) 727-7303

713 Northcreek Dr
Laredo, TX 78041-3287

Hospital & facility affiliations

  • Laredo Medical Center Hospital, Laredo, TX, CCN 450029

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
K9224TXMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gateway Community Health Center, Inc CurrentSince Dec 30, 2019 Accepting new patients
Gateway Community Health Center, Inc CurrentSince Dec 30, 2019 Accepting new patients
Laredo Womens Center, P.a. Obstetrics & Gynecology CurrentSince Sep 1, 2004 Accepting new patients
Laredo Texas Hospital Company LP Past Accepting new patients
Gateway Community Health Center, Inc. Past Accepting new patients

Locations

208 Shiloh Dr
Ste 1
Laredo, TX 78045
Phone (956) 718-6281

1020 E Hillside Rd
Laredo, TX 78041
Phone (956) 727-7303

1515 Pappas St
Laredo, TX 78041
Phone (956) 523-3642

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277856000000",
    "number": "1972504181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 E HILLSIDE RD",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780413287",
            "telephone_number": "956-727-7303",
            "fax_number": "956-726-1224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 E HILLSIDE RD",
            "city": "LAREDO",
            "state": "TX",
            "postal_code": "780413287",
            "telephone_number": "956-727-7303",
            "fax_number": "956-726-1224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENAVIDES",
        "first_name": "ENRIQUE",
        "middle_name": "F",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2010-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "K9224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100796503",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laredo, TX

Sources for this page

Verify at the official NPI Registry.