Provider Demographics
NPI:1700205515
Name:STARLIGHT PEDIATRICS, PLLC
Entity Type:Organization
Organization Name:STARLIGHT PEDIATRICS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/ORGANIZER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTRO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-762-5113
Mailing Address - Street 1:500 HOLLY SPRINGS RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-6204
Mailing Address - Country:US
Mailing Address - Phone:919-762-5113
Mailing Address - Fax:919-762-5130
Practice Address - Street 1:500 HOLLY SPRINGS RD
Practice Address - Street 2:SUITE 101
Practice Address - City:HOLLY SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:27540-6204
Practice Address - Country:US
Practice Address - Phone:919-762-5113
Practice Address - Fax:919-762-5130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-09
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2006-01271208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty