Individual
DR. MARY JANE WRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., PHD
Contact information
Practice address
1602 HILL ST, BASTROP, TX 78602-2525
(512) 772-4887
(830) 875-6398
Mailing address
PO BOX 1890, GONZALES, TX 78629-1390
(830) 672-6511
Taxonomy
Speciality
Code
Description
License number
State
2080P0205X
Pediatric Endocrinology Physician
Primary
G4757
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0074KV
BCBS PROVIDER ID
TX
05
—
137109801
—
TX
Enumeration date
03/14/2006
Last updated
07/11/2024
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