# CENTRAL TEXAS PEDIATRIC ENDOCRINOLOGY AND DIABETES, P.A.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** The Whole Child Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104973171
- **Authorized official:** DR. MARY JANE WRAY M.D., PHD (PRESIDENT)
- **Authorized official phone:** (512) 467-9444

## Contact information

- **Practice address:** 3303 NORTHLAND DR, SUITE 308, AUSTIN, TX 78731-4945
- **Practice address phone:** (512) 467-9444
- **Practice address fax:** (512) 467-9550
- **Mailing address:** PO BOX 140494, AUSTIN, TX 78714-0494
- **Mailing address phone:** (512) 467-9444
- **Mailing address fax:** (512) 467-9550

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | G4757 | TX | Yes |

## Other

- **Enumeration date:** 01/04/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0074KV | BCBS ID | TX |