Mimi Song Idicula is a Irving, Texas based female chiropractor with 7 years of experience in General Chiropractor. She completed her graduation from Other 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. Mimi Song Idicula is qualified as a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
Complete Profile:
Mimi Song Idicula speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
Specialization:
Chiropractor
Credentials:
NP
Experience:
7+ years
Medical School Attended:
Other
Graduation Year:
2017
Gender:
Female
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:
Doctors 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
General Chiropractor
Texas
Secondary
Group Practice:
Group practices are practice of medicine by a group of physicians 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:
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. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 11 March, 2024.