Individual
SHERMAN WAYNE WIENEKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AGNP
Contact information
Practice address
4502 MEDICAL DR, SAN ANTONIO, TX 78229
(210) 358-8555
(210) 358-8576
Mailing address
4502 MEDICAL DR, SAN ANTONIO, TX 78229-4402
(210) 358-8555
(210) 358-8576
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
0187139
CO
363LA2200X
Adult Health Nurse Practitioner
Primary
AP131815
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
391086101
—
TX
01
—
391086102
CSHCN
TX
Enumeration date
08/22/2016
Last updated
01/10/2019
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