=====================================================
General NPI Number Information
=====================================================
NPI Number | 1104630185
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EAT RIGHT WITH DR PENG LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/01/2025
-----------------------------------------------------
Last Update Date | 12/09/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3001 S HARDIN BLVD STE 110
-----------------------------------------------------
City | MCKINNEY
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75070-7702
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 443-315-3611
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3001 S HARDIN BLVD STE 110
-----------------------------------------------------
City | MCKINNEY
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75070-7702
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 443-315-3611
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER & MANAGING MEMBER
-----------------------------------------------------
Name | LI-LING PENG
-----------------------------------------------------
Credential | PHD, RD, LD
-----------------------------------------------------
Telephone | 443-315-3611
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 133V00000X
-----------------------------------------------------
Taxonomy Name | Registered Dietitian
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------