Mimi Song Idicula, NP is a medicare enrolled "Nurse Practitioner" provider in Irving, Texas. Her current practice location is
6161 N State Highway 161, Irving, Texas. You can reach out to her office (for appointments etc.) via phone at
(972) 258-7499.
Mimi Song Idicula is licensed to practice in Texas (license number AP137449) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1003009580.
Healthcare Provider's Profile
| Full Name | Mimi Song Idicula |
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| Gender | Female |
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| Speciality | |
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| Experience | Years |
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| Location | 6161 N State Highway 161, Irving, Texas |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Mimi Song Idicula attended and graduated from in
NPI Data:
- NPI Number: 1003009580
- Provider Enumeration Date: 08/20/2007
- Last Update Date: 07/13/2021
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Mimi Song Idicula such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1003009580 | NPI | - | NPPES |
| AP137449 | Other | TX | NURSE PRACTITIONER |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 111N00000X | Chiropractor | 10049 (Texas) | Secondary |
| 363L00000X | Nurse Practitioner | AP137449 (Texas) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mimi Song Idicula is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Mimi Song Idicula, NP
6161 N State Highway 161,
Irving, TX 75038-2220
Ph: (972) 258-7499 | Mimi Song Idicula, NP
6161 N State Highway 161,
Irving, TX 75038-2220
Ph: (972) 258-7499 |
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