Individual provider Active NPI

C Funsho Fagbohun, M.D., PH.D.

  • Obstetrics & Gynecology Physician
  • Richmond, TX
National Provider Identifier
1629016415
Registry record updated Mar 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
K3176 Issued in TX
Practice address
1601 Liberty St
Suite a
Richmond, TX 77469-3252
Phone
(281) 342-6962
Fax
(281) 342-6963
NPI assigned
Jun 3, 2006
Last updated
Mar 26, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X K3176 TX Primary

Addresses

Primary practice location

1601 Liberty St
Suite a
Richmond, TX 77469-3252

Mailing address

1601 Liberty St
Suite a
Richmond, TX 77469-3252
Phone (281) 342-6962

Other practice location 1

400 Austin St
Richmond, TX 77469-4406
Phone (281) 342-4530

Other identifiers 1

IdentifierTypeStateIssuer
141965701MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040825001523 TX Practitioner - Obstetrics/Gynecology 6103890942 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
C.Funsho Fagbohun,MD,PHD PA Obstetrics & Gynecology CurrentSince May 24, 2001 Accepting new patients
Memorial Hermann Health System Past Accepting new patients
Oakbend Medical Center Past Accepting new patients

Locations

1601 Liberty St
Ste A
Richmond, TX 77469
Phone (281) 305-3142

1601 Main St
Ste 206
Richmond, TX 77469
Phone (281) 342-3741

7790 W Grand Pkwy S
Ste 201
Richmond, TX 77406
Phone (281) 342-6962

7619 Branford Pl
Ste 260
Sugar Land, TX 77479
Phone (281) 342-6952

10119 US 59 Hwy
Wharton, TX 77488
Phone 9792452008302

Interoperability endpoints

  • Direct secure messaging: cfagbohun65673@memorialhermann.direct-ci.com
  • Direct secure messaging: funsho.fagbohun.p1@direct.accesshealth.nextgenshare.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774483200000",
    "number": "1629016415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 LIBERTY ST",
            "address_2": "SUITE A",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774693252",
            "telephone_number": "281-342-6962",
            "fax_number": "281-342-6963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 LIBERTY ST",
            "address_2": "SUITE A",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774693252",
            "telephone_number": "281-342-6962",
            "fax_number": "281-342-6963"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Austin St",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "TX",
            "postal_code": "774694406",
            "country_code": "US",
            "telephone_number": "281-342-4530",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAGBOHUN",
        "first_name": "C FUNSHO",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2026-03-26",
        "certification_date": "2026-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "K3176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "141965701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, TX

Sources for this page

Verify at the official NPI Registry.