Beth Boldery, REEG/EPT,CNIM
Specialist/Technologist, Other, EEG in Tyler, TX. Individual provider (NPI-1).
NPI number1942777164
StatusActive
Last updated in NPPESMay 8, 2019
Details
- NPI
- 1942777164
- Entity type
- Individual (NPI-1)
- Name
- Beth Boldery
- Credential
- REEG/EPT,CNIM
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Oct 25, 2018
- Last updated
- May 8, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 246ZE0500X | Specialist/Technologist, Other, EEG | 526 | TX | Yes |
| 246ZS0410X | Specialist/Technologist, Other, Surgical Technologist | – | – | |
| 2472E0500X | Technician, Other, EEG | 3497 | TX |
Practice location
1356 Old Creek DrTyler, TX 75703-7642
Phone 903-534-8812 · Fax 903-939-9149
Mailing address
1356 Old Creek DrTyler, TX 75703-7642
Phone 903-534-8812 · Fax 903-939-9149
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