Andrea Sue Wenner, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

BP10043663 Issued in TX

Practice address

4604 NE Stallings Dr
Nacogdoches, TX 75965-1608

Phone

(936) 560-5668

NPI assigned

Apr 27, 2012

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: andrea.wenner.p65@direct.tenet.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• East Texas Community Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Nacogdoches, TX
  • NPI 1255367090

  Pediatrics

  Medicare reassignment NPD
• East Texas Community Health Services, Inc

  • Community/Retail Pharmacy
  • Nacogdoches, TX
  • NPI 1457216665
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1335484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778112000000",
    "number": "1073871976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 CARDOVA DR",
            "city": "MAX MEADOWS",
            "state": "VA",
            "postal_code": "243603651",
            "telephone_number": "936-371-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4604 NE STALLINGS DR",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759651608",
            "telephone_number": "936-560-5668"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2401 S 31st St",
            "address_purpose": "LOCATION",
            "city": "Temple",
            "state": "TX",
            "postal_code": "765080001",
            "country_code": "US",
            "telephone_number": "254-724-9290",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WENNER",
        "first_name": "ANDREA",
        "middle_name": "SUE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-27",
        "last_updated": "2026-05-07",
        "certification_date": "2026-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "BP10043663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• T Lynn Warthan, MD
• Melinda Watts, ATC
• Daniel Allison Weaver, D.D.S.,M.S
• Deana Marie Weaver
• Christy Michelle Webb, LMSW
• Melinda E. Wenner, DO
• Janet Westbrook, OTR
• Westward I Enterprises, LLC (Westward Trails Nursing and Rehabilitation)
• Westward Nursing and Rehabilitation, LP (Westward Trails Nursing and Rehabilitation)
• Westward Trails Operator LLC (Westward Trails Health and Rehab)

• Pediatrics Physician in Nacogdoches, TX
• Providers in Nacogdoches, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.