Provider Demographics
NPI:1659243327
Name:HICO TOTAL HEALTH AND WELLNESS
Entity type:Organization
Organization Name:HICO TOTAL HEALTH AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:WYATT
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:254-374-0430
Mailing Address - Street 1:800 N SECOND ST
Mailing Address - Street 2:
Mailing Address - City:HICO
Mailing Address - State:TX
Mailing Address - Zip Code:76457-6261
Mailing Address - Country:US
Mailing Address - Phone:254-374-0430
Mailing Address - Fax:254-442-0400
Practice Address - Street 1:800 N SECOND ST
Practice Address - Street 2:
Practice Address - City:HICO
Practice Address - State:TX
Practice Address - Zip Code:76457-6261
Practice Address - Country:US
Practice Address - Phone:254-374-0430
Practice Address - Fax:254-442-0400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-22
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083T0002XAllopathic & Osteopathic PhysiciansPreventive MedicineMedical ToxicologyGroup - Multi-Specialty
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty