| Amoxie Group | |
|
705 Acadia St Mansfield TX 76063-4104 | |
| (817) 706-4652 | |
| Not Available |
| Full Name | Amoxie Group |
|---|---|
| Speciality | Clinic/Center |
| Location | 705 Acadia St, Mansfield, Texas |
| Authorized Official Name and Position | Akweta E Hickman (CHIEF EDUCATION OFFICER) |
| Authorized Official Contact | 8177064652 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Amoxie Group 900 N Walnut Creek Dr Ste 100-pmb 394 Mansfield TX 76063 Ph: (817) 706-4652 | Amoxie Group 705 Acadia St Mansfield TX 76063-4104 Ph: (817) 706-4652 |
| NPI Number | 1215680657 |
|---|---|
| Provider Enumeration Date | 01/26/2022 |
| Last Update Date | 04/17/2023 |
| Certification Date | 04/17/2023 |
| Medicare PECOS PAC ID | 3375907421 |
|---|---|
| Medicare Enrollment ID | O20230908000371 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215680657 | NPI | - | NPPES |
| Provider Name | Chandler Ude |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1962782045 PECOS PAC ID: 4385008176 Enrollment ID: I20230912003658 |
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