Provider Demographics
NPI:1245363902
Name:PENG, DAVID DAIXUN (LAC)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:DAIXUN
Last Name:PENG
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9968 BELLAIRE BLVD
Mailing Address - Street 2:SUITE 210B
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-3460
Mailing Address - Country:US
Mailing Address - Phone:713-248-3191
Mailing Address - Fax:713-271-8183
Practice Address - Street 1:9968 BELLAIRE BLVD
Practice Address - Street 2:SUITE 210B
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-3460
Practice Address - Country:US
Practice Address - Phone:713-248-3191
Practice Address - Fax:713-271-8183
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC00561171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist