Mimi Song Idicula
Chiropractor Nurse Practitioner
6161 N State Highway 161
Irving
, Texas 75038-2220
Mimi Song Idicula
Chiropractor Nurse Practitioner
6161 N State Highway 161
Irving
, Texas 75038-2220
(972) 257-0897
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About
Features
Specialties
- Chiropractor
- Nurse Practitioner
Languages spoken
- English
Location
First Address
- Mimi Song Idicula
- 6161 N State Highway 161
- Irving, TX
- Zip : 75038-2220
- Fax : (972) 257-0897
- Phone : (972) 258-7499
Second Address
- Mimi Song Idicula
- 6161 N State Highway 161
- Irving, TX
- Zip : 75038-2220
- Fax : (972) 257-0897
- Phone : (972) 258-7499
Reviews
FAQs
Where did Mimi Song Idicula attend graduate school?
Where did Mimi Song Idicula do her residency?
Where did Mimi Song Idicula do her fellowship?
Is Mimi Song Idicula board certified?
What type of doctor is Mimi Song Idicula
In what state does Mimi Song Idicula practice in?
Where is Mimi Song Idicula ’s practice located?
What is Mimi Song Idicula ’s gender?
Is Mimi Song Idicula a sole practitioner?
Is Mimi Song Idicula accepting new patients?
What languages does Mimi Song Idicula speak?
Does Mimi Song Idicula accept insurance?
Does Mimi Song Idicula offers telemedicine?
What is Mimi Song Idicula ’s professional license number?
What is Mimi Song Idicula ’s NPI number?
Does Mimi Song Idicula have any license restrictions?
Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 111N00000X | Chiropractor | 10049 | TX |
| Y | 363L00000X | Nurse Practitioner | AP137449 | TX |
National Provider Identifier
| NPI | 1003009580 |
|---|---|
| Provider Name | Mimi Song Idicula |
| First Address | Irving, TX 75038-2220 |
| Second Address | Irving, TX 75038-2220 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 20/08/2007 |
| Last Update Date | 13/07/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| AP137449 | NURSE PRACTITIONER (01) | TX |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.