Provider Demographics
NPI:1790829018
Name:HAN, LILY CHENG (MD)
Entity Type:Individual
Prefix:
First Name:LILY
Middle Name:CHENG
Last Name:HAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 733784
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-3784
Mailing Address - Country:US
Mailing Address - Phone:682-885-6483
Mailing Address - Fax:682-885-3113
Practice Address - Street 1:5680 FRISCO SQUARE BLVD STE 1200
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-3323
Practice Address - Country:US
Practice Address - Phone:972-403-5437
Practice Address - Fax:972-403-5438
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK8197208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8J3200OtherBLUE CROSS PROVIDER
TX8J3200OtherBLUE CROSS PROVIDER
TXH11690Medicare UPIN