Healthcare Provider Details

I. General information

NPI: 1700557352
Provider Name (Legal Business Name): PRINCETON PEDIATRICS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2021
Last Update Date: 12/24/2025
Certification Date: 12/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

136 S 2ND ST
PRINCETON TX
75407-6562
US

IV. Provider business mailing address

136 S 2ND ST
PRINCETON TX
75407-6562
US

V. Phone/Fax

Practice location:
  • Phone: 972-215-8703
  • Fax:
Mailing address:
  • Phone: 469-581-8115
  • Fax: 469-581-8114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: BEEZER MOOLJI
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 972-215-8703