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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

KACIE WALLACE GONZALES

Active

KACIE WALLACE GONZALES is a Physician Assistant healthcare provider located in BRYAN, Texas. NPI 1649899600 is currently active in the NPPES registry. Verify at CMS.

Physician Assistant · BRYAN, TX

Registration Details

NPI Number
1649899600
Provider Type
Individual
Gender
Female
NPI Issued
Apr 10, 2020 (6.3308554085791 yrs)
Last Updated
Jan 29, 2026
Licenses
3181 (OK)
14298 (TX)

Practice Information

Address
2215 E VILLA MARIA RD STE 110
BRYAN, TX, 778022585
Browse TX providers · Browse ZIP 77802
Phone
9797762000
Fax
8667332572
Primary Specialty
Physician Assistant
363A00000X
Additional Specialty
Physician Assistant

Other Physician Assistant Providers in BRYAN, TX

Name Credential NPI
LORRAINE WASHBURN PA-C 1659325272
MS. AMBER ANISE MICK P.A 1700971074
JENNIFER D RIGGENS PA-C 1992824775
RICHARD LAWRENCE DELEZENE PA-C 1982724134
MISS ELLEN ELIZABETH SUGAREK PA-C 1831372259
JILL MICHELLE WHITLEY PA-C 1003072174
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.