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

Mickaella Lee Herridge, ATC, MAT, LAT

Individual provider Athletic Trainer · NPI 1740165117

Mickaella Lee Herridge, ATC, MAT, LAT is an Athletic Trainer in Bullard, Texas. Licensed in Texas. Registered with an NPI since 2025.

Licensed in
TX
In the registry since
2025
What do these letters mean?
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.
LAT — Licensed Athletic Trainer
A state-licensed athletic trainer.

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Practice location Address checks out

1426 S Houston St
Bullard, TX 75757-5555
Phone: (903) 894-2862
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence AT9595 (TX)

Record details

NPI number1740165117
Entity typeIndividual (Type 1)
GenderFemale
Credentials ATC , MAT , LAT
Sole proprietorNo
NPI enumeratedAugust 6, 2025
Last updated in NPPESAugust 6, 2025
Certification dateAugust 6, 2025

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