Provider Demographics
NPI:1811633423
Name:ARGO WELLNESS AND HYDRATION CLINIC
Entity type:Organization
Organization Name:ARGO WELLNESS AND HYDRATION CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PETRA
Authorized Official - Middle Name:
Authorized Official - Last Name:WYCHE
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:254-213-8048
Mailing Address - Street 1:3306 SEVILLA DR
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-2599
Mailing Address - Country:US
Mailing Address - Phone:254-213-8048
Mailing Address - Fax:
Practice Address - Street 1:2157 N HWY 116
Practice Address - Street 2:
Practice Address - City:COPPERAS COVE
Practice Address - State:TX
Practice Address - Zip Code:76522
Practice Address - Country:US
Practice Address - Phone:254-213-8048
Practice Address - Fax:254-432-6018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-06
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care