Basic Information
| Provider Information | |||||||||
| NPI: | 1558709881 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GAVINO | ||||||||
| FirstName: | CHRISTINE | ||||||||
| MiddleName: | KAY | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2912 VILLAGE BROOK LN | ||||||||
| Address2: | |||||||||
| City: | PEARLAND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 775843484 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8322764079 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 6912 FM 1488 RD STE A | ||||||||
| Address2: | |||||||||
| City: | MAGNOLIA | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773541527 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2813561945 | ||||||||
| FaxNumber: | 2813561978 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/09/2013 | ||||||||
| LastUpdateDate: | 07/14/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | Q6192 | TX | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.