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General NPI Number Information
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NPI Number | 1427047588
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Entity Type | Individual
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Provider Name | EVA D BOLDRIDGE DMD
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Gender | Female
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Dates
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Enumeration Date | 10/20/2005
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Last Update Date | 12/17/2024
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Provider Practice Location Address
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Address Line | 7676 WOODWAY DR STE 310
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City | HOUSTON
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State | TX
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Zip | 77063-1523
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Country | US
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Telephone | 281-597-1800
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Fax | 713-781-7877
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Provider Business Mailing Address
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Address Line | 7676 WOODWAY DR STE 310
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City | HOUSTON
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State | TX
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Zip | 77063-1523
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Country | US
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Telephone | 281-597-1800
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Fax | 713-781-7877
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 21677
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License Number State | TX
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