MEDICARE: BRIGHT STARS PEDIATRICS, PA

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

General Provider Information

NPI Number	:	1093916157
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIGHT STARS PEDIATRICS, PA

Provider Business Mailing 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

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	:	OWNER
Name	:	KAREN ALEXIS PILGRIM-KING
Credential	:	M.D.
Telephone Number	:	817-277-1329

Provider Enumeration Date	:	05/29/2007
Last Update Date	:	08/22/2020

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