Provider Demographics
NPI:1891484317
Name:GOSINE, KAVELLE SYRA (DO)
Entity type:Individual
Prefix:DR
First Name:KAVELLE
Middle Name:SYRA
Last Name:GOSINE
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 1:7615 KENNEDY HL BLDG 1
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78235-4438
Mailing Address - Country:US
Mailing Address - Phone:210-890-4243
Mailing Address - Fax:
Practice Address - Street 1:7615 KENNEDY HL BLDG 1
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78235-4438
Practice Address - Country:US
Practice Address - Phone:210-283-6998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-01
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program