Provider Demographics
NPI:1598575433
Name:BENLAZREG, LAILA
Entity type:Individual
Prefix:MS
First Name:LAILA
Middle Name:
Last Name:BENLAZREG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15330 ELLA BLVD APT 1512
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-5328
Mailing Address - Country:US
Mailing Address - Phone:713-823-4257
Mailing Address - Fax:
Practice Address - Street 1:2111 WEST LOOP S STE 150
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-3647
Practice Address - Country:US
Practice Address - Phone:713-823-4257
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician