MEDICARE: DR. KAREN ALEXIS PILGRIM-KING M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	M0529	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8W4320	OTHER	TX	BCBS PROVIDER ID
2	7604028	OTHER	TX	AETNA PROVIDER NUMBER
3	10060071	OTHER	TX	AMERIGROUP PROVIDER ID
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205888682
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAREN ALEXIS PILGRIM-KING M.D.

Provider Business Mailing Address
First Line	:	4808 GRAPEVINE TER
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76123-2920
Country	:	US
Telephone Number	:	817-346-2153
Fax Number	:	817-292-7985

Provider Business Practice Location Address
First Line	:	1126 W PIONEER PKWY
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76013-6367
Country	:	US
Telephone Number	:	817-277-1329
Fax Number	:	817-277-1369

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	07/09/2007

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Directions to “ DR. KAREN ALEXIS PILGRIM-KING M.D.” Practice Location

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