Organization
CENTRAL TEXAS PEDIATRIC ENDOCRINOLOGY AND DIABETES, P.A.
Active
Other names
The Whole Child Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY JANE WRAY M.D., PHD (PRESIDENT)
(512) 467-9444
Entity
Organization
Contact information
Practice address
3303 NORTHLAND DR, SUITE 308, AUSTIN, TX 78731-4945
(512) 467-9444
(512) 467-9550
Mailing address
PO BOX 140494, AUSTIN, TX 78714-0494
(512) 467-9444
(512) 467-9550
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
G4757
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0074KV
BCBS ID
TX
Enumeration date
01/04/2007
Last updated
08/22/2020
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