Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Andrew Gonzalo Palacios

Individual provider Physician Assistant · NPI 1609507466

Andrew Gonzalo Palacios is a Physician Assistant in Tyler, Texas. Qualified in 2023, 3 years ago. Practices with Etmc Physician Group, Inc, a 376-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
3
Licensed in
TX
In the registry since
2022
Specialties on file
2
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Practice location Address checks out

1020 E Idel St
Tyler, TX 75701-2024
Phone: (903) 535-2902
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence PA17722 (TX)
Physician Assistant Taxonomy 363A00000X · Licence PA17722 (TX)

Record details

NPI number1609507466
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJune 22, 2022
Last updated in NPPESMarch 29, 2024
Certification dateMarch 29, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Etmc Physician Group, Inc. — 376 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Tyler