DR. LACI DESIRAE WANER (MD) – Family Medicine Physician, NPI 1487975827

DR. LACI DESIRAE WANER (MD) is a healthcare provider. based in Clifton, Texas. specializing in Family Medicine Physician. They hold the professional credentials MD. They hold a License No. 0101272445 (VA). The NPI Number for DR. LACI DESIRAE WANER (MD) is 1487975827

Main info

Female
Sole Proprietor
Name
DR. LACI DESIRAE WANER (MD)
NPI
1487975827
Phone
(979) 575-7936
Address
2710 OAK RDG
Enumeration Date
21 June 2010
Last Update Date
20 November 2025
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience80
Completeness85
Years active:15State licenses:7Digital endpointsOther names

Provider Addresses for DR. LACI DESIRAE WANER (MD)

  • 2710 OAK RDG

    CLIFTON, TX 766341162

    Phone: (979) 575-7936

    Fax: (502) 385-6556

    Type: Mailing

  • 2800 Eisenhower Ave Ste 220

    Alexandria, VA 223144587

    Phone: (888) 803-3370

    Fax: (888) 803-3331

    Type: Location

  • 100 NE 5th St

    Oklahoma City, OK 731042228

    Phone: (888) 803-3370

    Fax: (888) 803-3331

    Type: Location

  • 1400 N Coit Rd Ste 302

    McKinney, TX 750716656

    Phone: (888) 803-3370

    Fax: (888) 803-3331

    Type: Location

  • 5373 W ALABAMA ST STE 204

    Houston, TX 770565923

    Phone: (888) 803-3370

    Fax: (888) 803-3331

    Type: Location

  • 333 1ST ST STE A

    SAN FRANCISCO, CA 941052661

    Phone: (888) 803-3370

    Fax: (888) 803-3331

    Type: Location

  • 525 N Tryon St Ste 1600

    Charlotte, NC 282020213

    Phone: (888) 803-3370

    Fax: (888) 803-3331

    Type: Location

  • 71 Raymond Rd Ste 122

    West Hartford, CT 061072211

    Phone: (888) 803-3370

    Fax: (888) 803-3331

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2017-03-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20170316000822IFamily PracticeTXTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 76634)

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Reviews

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Frequently asked questions

How do payers reference DR. LACI DESIRAE WANER (MD)?
For DR. LACI DESIRAE WANER (MD), use NPI 1487975827 as the unique 10-digit identifier.
Is there an active status for DR. LACI DESIRAE WANER (MD)?
For scheduling context, DR. LACI DESIRAE WANER (MD) is shown as active in the registry.
How would a patient describe DR. LACI DESIRAE WANER (MD)'s focus?
For DR. LACI DESIRAE WANER (MD), the primary taxonomy reads as Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Is DR. LACI DESIRAE WANER (MD) located near Clifton?
DR. LACI DESIRAE WANER (MD) currently maps to Clifton, Texas in this extract.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.