Provider Demographics
NPI:1093916157
Name:BRIGHT STARS PEDIATRICS, PA
Entity Type:Organization
Organization Name:BRIGHT STARS PEDIATRICS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:ALEXIS
Authorized Official - Last Name:PILGRIM-KING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-277-1329
Mailing Address - Street 1:1126 W PIONEER PKWY
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76013-6367
Mailing Address - Country:US
Mailing Address - Phone:817-277-1329
Mailing Address - Fax:817-277-1369
Practice Address - Street 1:1126 W PIONEER PKWY
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76013-6367
Practice Address - Country:US
Practice Address - Phone:817-277-1329
Practice Address - Fax:817-277-1369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM0529208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty