Healthcare Provider Details

I. General information

NPI: 1104040591
Provider Name (Legal Business Name): INTERNAL MEDICINE AND WOMENS AND CHILDRENS CLINIC PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 E SAUNDERS ST
LAREDO TX
78041-5401
US

IV. Provider business mailing address

PO BOX 2354
LAREDO TX
78044-2354
US

V. Phone/Fax

Practice location:
  • Phone: 956-796-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License NumberJ9579
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberJ9579
License Number StateTX

VIII. Authorized Official

Name: DR. RICHARD B DEBENEDETTO
Title or Position: OWNER
Credential: MD
Phone: 806-236-5938