Provider Demographics
NPI:1598245078
Name:ELDRIDGE, GEORGINA MARGARITA (CNM)
Entity Type:Individual
Prefix:
First Name:GEORGINA
Middle Name:MARGARITA
Last Name:ELDRIDGE
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:GEORGINA
Other - Middle Name:MARGARITA
Other - Last Name:AGUILAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:700 N SAM HOUSTON PKWY W
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77067-4335
Mailing Address - Country:US
Mailing Address - Phone:832-828-1005
Mailing Address - Fax:
Practice Address - Street 1:1504 TAUB LOOP
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1608
Practice Address - Country:US
Practice Address - Phone:713-873-8794
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-15
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP136693367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife