Laci Desirae Waner, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

R1902 Issued in TX

Practice address

2710 Oak RDG
Clifton, TX 76634-1162

Phone

(254) 978-5224

Fax

(502) 385-6556

NPI assigned

Jun 21, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 7

Addresses

Other identifiers 2

Other names 1

• Laci Desirae Stephenson Former name

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 Medicine

State licenses

Practice roles

Locations

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.

• Circle Medical Care Group PA

  • Family Medicine Physician
  • Tampa, FL
  • NPI 1972358760

  Single Specialty, TX

  Medicare reassignment NPD

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

{
    "created_epoch": "1277078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763596800000",
    "number": "1487975827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2710 OAK RDG",
            "city": "CLIFTON",
            "state": "TX",
            "postal_code": "766341162",
            "telephone_number": "979-575-7936",
            "fax_number": "502-385-6556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2710 OAK RDG",
            "city": "CLIFTON",
            "state": "TX",
            "postal_code": "766341162",
            "telephone_number": "254-978-5224",
            "fax_number": "502-385-6556"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2800 Eisenhower Ave Ste 220",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "VA",
            "postal_code": "223144587",
            "country_code": "US",
            "telephone_number": "888-803-3370",
            "fax_number": "888-803-3331",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1400 N Coit Rd Ste 302",
            "address_purpose": "LOCATION",
            "city": "McKinney",
            "state": "TX",
            "postal_code": "750716656",
            "country_code": "US",
            "telephone_number": "888-803-3370",
            "fax_number": "888-803-3331",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5373 W ALABAMA ST STE 204",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770565923",
            "country_code": "US",
            "telephone_number": "888-803-3370",
            "fax_number": "888-803-3331",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "333 1ST ST STE A",
            "address_purpose": "LOCATION",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941052661",
            "country_code": "US",
            "telephone_number": "888-803-3370",
            "fax_number": "888-803-3331",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "525 N Tryon St Ste 1600",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282020213",
            "country_code": "US",
            "telephone_number": "888-803-3370",
            "fax_number": "888-803-3331",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "71 Raymond Rd Ste 122",
            "address_purpose": "LOCATION",
            "city": "West Hartford",
            "state": "CT",
            "postal_code": "061072211",
            "country_code": "US",
            "telephone_number": "888-803-3370",
            "fax_number": "888-803-3331",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 NE 5th St",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731042228",
            "country_code": "US",
            "telephone_number": "888-803-3370",
            "fax_number": "888-803-3331",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WANER",
        "first_name": "LACI",
        "middle_name": "DESIRAE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-21",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101272445",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CT",
            "license": "72317",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "R1902",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME143348",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2021-01835",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2021036991",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "29766",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "369616303",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "369616301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LACI",
            "last_name": "STEPHENSON",
            "middle_name": "DESIRAE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Harley Marie Thomas, COTA
• William P Trotter, MD
• Richard T Turner, M.D.
• Robert Lance Urbanovsky, D. C.
• Dee Anna Walker, DDS
• Jose Vernon Watson, MD
• Nicolas Welch, DPM
• Valerie Wells, LPCI
• Mary L Werlinger, DNP, APRN, FNP-BC
• West Wharton County Hospital District

• All providers in Clifton, TX
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2025; 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.