MEDICARE: PRINCETON PEDIATRICS, PLLC

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
2	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1700557352
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRINCETON PEDIATRICS, PLLC

Provider Business Mailing Address
First Line	:	136 S 2ND ST
Second Line	:
City	:	PRINCETON
State	:	TX
Zip	:	75407-6562
Country	:	US
Telephone Number	:	469-581-8115
Fax Number	:	469-581-8114

Provider Business Practice Location Address
First Line	:	136 S 2ND ST
Second Line	:
City	:	PRINCETON
State	:	TX
Zip	:	75407-6562
Country	:	US
Telephone Number	:	972-215-8703
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	BEEZER MOOLJI
Credential	:	MD
Telephone Number	:	972-215-8703

Provider Enumeration Date	:	09/23/2021
Last Update Date	:	02/17/2026

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