Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

McKennizie Boodram, LAT

Individual provider Contractor · NPI 1033586003

McKennizie Boodram, LAT is a Contractor in Desoto, Texas. Licensed in Texas. Registered with an NPI since 2015.

Licensed in
TX
In the registry since
2015
What do these letters mean?
LAT — Licensed Athletic Trainer
A state-licensed athletic trainer.

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Practice location Address checks out

1525 Mountain Laurel Ln
Desoto, TX 75115-5394
Phone: (469) 260-8872
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Contractor (primary) Taxonomy 171W00000X · Licence AT6271 (TX)

Record details

NPI number1033586003
Entity typeIndividual (Type 1)
GenderFemale
Credentials LAT
Sole proprietorNo
NPI enumeratedAugust 26, 2015
Last updated in NPPESAugust 26, 2015

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