Active NPI
Olasumbo Elizabeth Fagbenle, M.D.
- Pediatrics Physician
- Edinburg, TX
National Provider Identifier
1275285124
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 2021047578
- Practice address
- 2820 W Michaelangelo Dr
Edinburg, TX 78539-1402 - Phone
- (965) 558-6400
- NPI assigned
- Jan 21, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 2021047578 | TX | Primary |
| Family Medicine Physician | 207Q00000X | 2021047578 | MO |
Addresses
Primary practice location
2820 W Michaelangelo Dr
Edinburg, TX 78539-1402
Mailing address
2820 W Michaelangelo Dr
Edinburg, TX 78539-1402
Phone (956) 558-6400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2021047578 | Medicaid | MO |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | drfagbenle@gmail.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2021047578 | MO | MD | Family Medicine Physician |
| 2021047578 | TX | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1642723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1774396800000",
"number": "1275285124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2820 W MICHAELANGELO DR",
"city": "EDINBURG",
"state": "TX",
"postal_code": "785391402",
"telephone_number": "956-558-6400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2820 W MICHAELANGELO DR",
"city": "EDINBURG",
"state": "TX",
"postal_code": "785391402",
"telephone_number": "965-558-6400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAGBENLE",
"first_name": "OLASUMBO",
"middle_name": "ELIZABETH",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-01-21",
"last_updated": "2026-03-25",
"certification_date": "2026-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TX",
"license": "2021047578",
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MO",
"license": "2021047578",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2021047578",
"state": "MO"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "drfagbenle@gmail.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "3015 N Ballas Rd",
"city": "Saint Louis",
"state": "MO",
"country_code": "US",
"postal_code": "631312329",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Edinburg, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.