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SHINE PEDIATRICS AND WELLNESS CENTER P.A.
NPI 1609110832
Pediatrics in Richardson, TX

Active since November 09, 2012CLIA Certified · 3 labs
3600 SHIRE BLVD, SUITE 110, RICHARDSON, TX 75082(469) 333-1543(877) 878-9118 Get Directions Write a Review

NPPES record last updated: August 10, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 10, 2021, May 27, 2021 (2 updates tracked since 2021).

About Shine Pediatrics And Wellness Center P.a. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHINE PEDIATRICS AND WELLNESS CENTER P.A. (NPI 1609110832) is a healthcare organization registered as a pediatrics in Richardson, Texas and active in the NPI registry since November 2012. The organization holds 3 active CLIA laboratory certificates, maintains a secondary practice location in Fort Worth, and lists Randy Naidoo, President, as its authorized official.

NPPES Registry Identity

NPI1609110832
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameSHINE PEDIATRICS AND WELLNESS CENTER P.A.
Location Address3600 SHIRE BLVD, SUITE 110Richardson, TX 75082-2240
Mailing Address3600 Shire Blvd, Suite 110Richardson, TX 75082-2240 · (469) 333-1543 · Fax (877) 878-9118
Phone(469) 333-1543
Fax(877) 878-9118
Organization SubpartNo
Authorized OfficialRandy NaidooPresident · (469) 939-6336
Enumeration DateNovember 9, 2012
Last NPPES UpdateAugust 10, 20212 updates tracked since enumeration
NPPES CertifiedAugust 10, 2021
✔ NPI 1609110832 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in TX · M0506
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X
Also ListedPsychiatry & Neurology · Child & Adolescent PsychiatryTaxonomy 2084P0804X
3600 SHIRE BLVD, Richardson, TX 75082
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Secondary Practice Location 1

Location 15009 Byers AveFort Worth, TX 76107-3625 · Phone (469) 333-1543 · Fax (877) 878-9118

Group Practice 2

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP
Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 3

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D2057774

Shine Pediatrics And Wellness Center, PA · Richardson, TX
Active · expires Apr 22, 2027
CLIA Number45D2057774
Laboratory TypePhysician Office
Certificate Effective DateApril 23, 2025
Certificate Expiration DateApril 22, 2027
Laboratory DirectorRandy M. Naidoo
Laboratory Phone(469) 333-1543
Laboratory LocationShine Pediatrics And Wellness Center, PA3600 Shire Blvd, Ste 110, Richardson, TX 75082
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 45D2317804

Shine Pediatrics And Wellness Center · Mckinney, TX
Active · expires Jan 30, 2027
CLIA Number45D2317804
Laboratory TypePhysician Office
Certificate Effective DateJanuary 31, 2025
Certificate Expiration DateJanuary 30, 2027
Laboratory DirectorRandy Naidoo
Laboratory Phone(469) 333-1543
Laboratory LocationShine Pediatrics And Wellness Center6251 W University Drive Ste 102, Mckinney, TX 75071
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 45D2232281

Shine Pediactrics & Wellness Center · Fort Worth, TX
Active · expires Aug 10, 2027
CLIA Number45D2232281
Laboratory TypePhysician Office
Certificate Effective DateAugust 11, 2025
Certificate Expiration DateAugust 10, 2027
Laboratory DirectorRandy Naidoo
Laboratory Phone(469) 333-1543
Laboratory LocationShine Pediactrics & Wellness Center1650 N Rosedale St Suite 200, Fort Worth, TX 76104
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. RANDY MEL NAIDOO M.D.
Pediatrics
3600 SHIRE BLVD, SUITE 110
RICHARDSON, TX 75082
Dallas County (469) 333-1543
DR. MARK LOUIS BAILEY M.D.
Surgery
3600 SHIRE BLVD, STE 104
RICHARDSON, TX 75082
Dallas County (972) 487-6400
ADRIAN JONES MS, LPC
Counselor (Professional)
3600 SHIRE BLVD
RICHARDSON, TX 75082
Dallas County (214) 556-0996
DR. RUSS DEACON BIRDWELL M.D.
Surgery
3600 SHIRE BLVD, SUITE 104
RICHARDSON, TX 75082
Dallas County (972) 487-6400
SHUQUETA THOMAS LMFT
Marriage & Family Therapist
3600 SHIRE BLVD
RICHARDSON, TX 75082
Dallas County (214) 556-0996

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shine Pediatrics And Wellness Center P.A.'s NPI number?

The NPI number for Shine Pediatrics And Wellness Center P.A. is 1609110832. It was assigned to this organization in the NPPES registry on November 9, 2012.

Where is Shine Pediatrics And Wellness Center P.A. located?

Shine Pediatrics And Wellness Center P.A. is located at 3600 Shire Blvd Suite 110, Richardson, TX 75082. The listed phone number is (469) 333-1543.

What is Shine Pediatrics And Wellness Center P.A.'s specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Shine Pediatrics And Wellness Center P.A. hold CLIA laboratory certificates?

Yes. 3 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Shine Pediatrics And Wellness Center P.A. was last updated on August 10, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.