Provider Demographics
NPI:1558709881
Name:GAVINO, CHRISTINE KAY (DO)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:KAY
Last Name:GAVINO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2912 VILLAGE BROOK LN
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-3484
Mailing Address - Country:US
Mailing Address - Phone:832-276-4079
Mailing Address - Fax:
Practice Address - Street 1:6912 FM 1488 RD STE A
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:TX
Practice Address - Zip Code:77354-1527
Practice Address - Country:US
Practice Address - Phone:281-356-1945
Practice Address - Fax:281-356-1978
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-09
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ6192207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine