Individual
DR. OLASUMBO ELIZABETH FAGBENLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2820 W MICHAELANGELO DR, EDINBURG, TX 78539-1402
(965) 558-6400
Mailing address
2820 W MICHAELANGELO DR, EDINBURG, TX 78539-1402
(956) 558-6400
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2021047578
MO
208000000X
Pediatrics Physician
2021047578
MO
208000000X
Pediatrics Physician
Primary
2021047578
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2021047578
—
MO
Enumeration date
01/21/2022
Last updated
03/25/2026
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