Kacie Wallace Gonzales

NPI #1649899600 in Bryan, Texas

Provider Information

NPI Number: 1649899600
Entity Type: Individual
Name: Kacie Wallace Gonzales
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Enumeration Date: Apr 10, 2020
Last Updated: Jan 29, 2026

Practice Location

Address: 2215 E VILLA MARIA RD STE 110
City: Bryan
State: Texas
ZIP Code: 77802-2585
Phone: (979) 776-2000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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