Mimi Song Idicula
NP | Nurse Practitioner | 8+ years Exp
6161 N State Highway 161, Irving
Texas, 75038-2220
972-258-7499
Mimi Song Idicula is a Irving, Texas based nurse practitioner with 8 years of experience in Nurse Practitioner. She completed her graduation in 2017. She accepts the Medicare-approved amount. Patients will not be billed for any more than the Medicare deductible and coinsurance. Active license number of Mimi Song Idicula is AP137449 in Texas. Her current practice location is 6161 N State Highway 161, Irving. Patients can reach her at 972-258-7499 or can fax her at 972-257-0897. Mimi Song Idicula is NP with specialization in Nurse Practitioner and her NPI number (Unique professional ID assigned by NPPES) is 1003009580.
Mimi Song Idicula has completed additional training beyond basic nursing education and provides primary health care services in accordance with state nurse practice laws or statutes. NPs are trained to assess patient needs, order and interpret diagnostic and laboratory tests, diagnose disease, formulate and prescribe medications and treatment plans.
Complete Profile:
Mimi Song Idicula speciality, credentials, practice address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointment.
| Name: | Mimi Song Idicula |
| Specialization: | Nurse Practitioner Nurse Practitioner (NP) |
| Gender: | Female |
| Credentials: | NP |
| Experience: | 8+ years |
| Medical School Attended: | Other |
| Graduation Year: | 2017 |
| Accepts Medicare Assignment: | Yes |
| Practice Address: | 6161 N State Highway 161, Irving,
Texas, 75038-2220 |
| Phone: | 972-258-7499 |
| Fax: | 972-257-0897 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| PAC ID: | 1052459120 |
| Enrollment ID: | I20190628000060 |
| NPI Number: | 1003009580 |
| NPI Enumeration Date: | 20 Aug, 2007 |
| NPI Last Update On: | 13 Jul, 2021 |
Medical Licenses:
NPs can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Mimi Song Idicula are as mentioned below.
| License Number | Specialization | State | Status | |
| AP137449 | | Texas | Primary | |
| 10049 | Chiropractor | Texas | Secondary | |
Group Practice:
Group practices are practice of medicine by a group of NPs who share their premises and other resources. Following list states all the group name
with which Mimi Song Idicula is associated with along with the number of members in that group.
| Organization Name (Group PAC ID) | Members |
| Healthcare Associates Of Irving Pllc (9335052489) | 85 |
Other Medical Identifiers:
Other legacy medical identifiers associated with Mimi Song Idicula such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| AP137449 | Other | Texas | NURSE PRACTITIONER |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Mimi Song Idicula
6161 N State Highway 161,
Irving, Texas |
| Zip: | 75038-2220 |
| Phone Number: | 972-258-7499 |
| Fax Number: | 972-257-0897 |
Patients can reach Mimi Song Idicula at
6161 N State Highway 161, Irving, Texas or can
call to book an appointment on 972-258-7499.
Comments/ Reviews:
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Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 13 October, 2025.