Healthcare Provider Details

I. General information

NPI: 1093916157
Provider Name (Legal Business Name): BRIGHT STARS PEDIATRICS, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1126 W PIONEER PKWY
ARLINGTON TX
76013-6367
US

IV. Provider business mailing address

1126 W PIONEER PKWY
ARLINGTON TX
76013-6367
US

V. Phone/Fax

Practice location:
  • Phone: 817-277-1329
  • Fax: 817-277-1369
Mailing address:
  • Phone: 817-277-1329
  • Fax: 817-277-1369

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberM0529
License Number StateTX

VIII. Authorized Official

Name: KAREN ALEXIS PILGRIM-KING
Title or Position: OWNER
Credential: M.D.
Phone: 817-277-1329