Individual
BETH BOLDERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REEG/EPT,CNIM
Contact information
Practice address
1356 OLD CREEK DR, TYLER, TX 75703-7642
(903) 534-8812
(903) 939-9149
Mailing address
1356 OLD CREEK DR, TYLER, TX 75703-7642
(903) 534-8812
(903) 939-9149
Taxonomy
Speciality
Code
Description
License number
State
246ZE0500X
EEG Specialist/Technologist
Primary
526
TX
246ZS0410X
Surgical Technologist
—
—
2472E0500X
EEG Technician
3497
TX
Other
Enumeration date
10/25/2018
Last updated
05/08/2019
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