Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MCKENNIZIE BOODRAM, LAT
ActiveMCKENNIZIE BOODRAM, LAT is a Contractor healthcare provider located in DESOTO, Texas. NPI 1033586003 is currently active in the NPPES registry. Verify at CMS.
Contractor · DESOTO, TX
Registration Details
- NPI Number
- 1033586003
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Aug 26, 2015 (10.926474837942 yrs)
- Last Updated
- Aug 26, 2015
- License
-
AT6271 (TX)
Practice Information
- Address
-
1525 MOUNTAIN LAUREL LNDESOTO, TX, 751155394Browse TX providers · Browse ZIP 75115
- Phone
- 4692608872
- Primary Specialty
-
Contractor
171W00000X
Other Contractor Providers in DESOTO, TX
| Name | Credential | NPI |
|---|---|---|
| BYRON SANDERS | — | 1538386693 |
| MR. CLIFFORD D. SCOTT | — | 1003051079 |
| MRS. FELICIA OLIVE LUCERO | — | 1851783021 |
| OLIVIA MOFFETT | — | 1679319750 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.