Provider Demographics
NPI:1134949522
Name:PENG, LI-LING (PHD, RD, LD)
Entity type:Individual
Prefix:DR
First Name:LI-LING
Middle Name:
Last Name:PENG
Suffix:
Gender:F
Credentials:PHD, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 S HARDIN BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-7702
Mailing Address - Country:US
Mailing Address - Phone:443-315-3611
Mailing Address - Fax:
Practice Address - Street 1:3001 S HARDIN BLVD STE 110
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-7702
Practice Address - Country:US
Practice Address - Phone:806-784-7508
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-11
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT89316133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered