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General NPI Number Information
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NPI Number | 1225967433
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Entity Type | Organization
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Legal Business Name | LAZERIT MED SPA LLC
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Dates
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Enumeration Date | 05/14/2026
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Last Update Date | 05/14/2026
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Provider Practice Location Address
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Address Line | 1705 E DEL MAR BLVD STE 108
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City | LAREDO
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State | TX
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Zip | 78041-6531
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Country | US
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Telephone | 956-722-1173
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Fax |
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Provider Business Mailing Address
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Address Line | 1705 E DEL MAR BLVD STE 108
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City | LAREDO
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State | TX
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Zip | 78041-6531
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Country | US
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Telephone | 956-722-1173
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Fax |
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Authorized Official
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Title or Position | OBGYN
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Name | DR. ENRIQUE FERNANDO BENAVIDES III
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Credential | MD
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Telephone | 956-727-7303
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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