=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275333833
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THE AMOXIE EDUCATIONAL CONSULTING GROUP LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/13/2025
-----------------------------------------------------
Last Update Date | 03/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 705 ACADIA ST
-----------------------------------------------------
City | MANSFIELD
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76063-4104
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 817-706-4652
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 705 ACADIA ST
-----------------------------------------------------
City | MANSFIELD
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76063-4104
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 817-706-4652
-----------------------------------------------------
Fax | 972-637-9328
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. AKWETA HICKMAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 817-706-4652
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 343800000X
-----------------------------------------------------
Taxonomy Name | Secured Medical Transport (VAN)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------