Provider Demographics
NPI:1427047588
Name:BOLDRIDGE, EVA D (DMD)
Entity type:Individual
Prefix:DR
First Name:EVA
Middle Name:D
Last Name:BOLDRIDGE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:EVA
Other - Middle Name:B
Other - Last Name:IZU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:7676 WOODWAY DR STE 310
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-1523
Mailing Address - Country:US
Mailing Address - Phone:281-597-1800
Mailing Address - Fax:713-781-7877
Practice Address - Street 1:7676 WOODWAY DR STE 310
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-1523
Practice Address - Country:US
Practice Address - Phone:281-597-1800
Practice Address - Fax:713-781-7877
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-20
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX216771223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics