{
"Npi": {
"NPI": "1659243327",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "HICO TOTAL HEALTH AND WELLNESS",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "800 N SECOND ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HICO",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "76457-6261",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "254-374-0430",
"MailingAddressFaxNumber": "254-442-0400",
"FirstLinePracticeLocationAddress": "800 N SECOND ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HICO",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "76457-6261",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "254-374-0430",
"PracticeLocationAddressFaxNumber": "254-442-0400",
"EnumerationDate": "09/22/2025",
"LastUpdateDate": "09/22/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WYATT",
"AuthorizedOfficialFirstName": "HEATHER",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "NP/OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "NP",
"AuthorizedOfficialTelephoneNumber": "254-374-0430",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "2083T0002X",
"TaxonomyName": "Medical Toxicology (Preventive Medicine) Physician",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
},
{
"TaxonomyCode": "261QM2500X",
"TaxonomyName": "Medical Specialty Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}