Mimi Song Idicula

Nurse Practitioner

Irving, TX 75038

Female - 5 Yrs Experience - English

Location

6161 N Hwy 161

Irving, TX 75038

Phone number

(972) 258-7499

Summary

Mimi Song Idicula is a Nurse Practitioner located at Irving, TX 75038 and is affiliated with Hospitals. She received her medical degree from Other and has been in practice for more than 5 years.

Professional Identification

  1. NPI#: 1003009580
  2. PAC ID: 1052459120
  3. Clinician Enrollment ID: I20190628000060
  4. Gender: Female
  5. Enumeration: August 20 2007
  6. Last Updated: July 13 2021

Medical Credentials

  1. Credential: Undefined
  2. Medical school: Other
  3. Graduation year: 2017
  4. Taxonomy: 363L00000X
  5. Specialty: Nurse Practitioner
  6. All specialties: Nurse Practitioner

Medical Practice

  1. Organization: Healthcare Associates Of Irving Llp
  2. Group PAC ID: 9335052489
  3. Number of Group Members: 73

Medicare Assignment

  1. Clinician accepts Medicare Assignment: Y
  2. Group accepts Medicare Assignment: Y

Locations

  1. 6161 N Hwy 161, Irving TX 75038 (972) 258-7499

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