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General NPI Number Information
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NPI Number | 1104040591
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Entity Type | Organization
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Legal Business Name | INTERNAL MEDICINE AND WOMENS AND CHILDRENS CLINIC PA
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Dates
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Enumeration Date | 04/13/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1700 E SAUNDERS ST
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City | LAREDO
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State | TX
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Zip | 78041-5401
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Country | US
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Telephone | 956-796-5000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2354
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City | LAREDO
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State | TX
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Zip | 78044-2354
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. RICHARD B DEBENEDETTO
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Credential | MD
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Telephone | 806-236-5938
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | J9579
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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License Number | J9579
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License Number State | TX
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