Central Texas Pediatric Endocrinology and Diabetes, P.a.

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

G4757 Issued in TX

Legal business name

CENTRAL TEXAS PEDIATRIC ENDOCRINOLOGY AND DIABETES, P.A.

Doing business as

The Whole Child Clinic

Practice address

3303 Northland Dr
Suite 308
Austin, TX 78731-4945

Phone

(512) 467-9444

Fax

(512) 467-9550

NPI assigned

Jan 4, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mary Jane Wray, M.D., PHDNPI 1588633499

Title

President

Phone

(512) 467-9444

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Whole Child Clinic Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mary Jane Wray, M.D., PHD

  • Pediatric Endocrinology Physician
  • Bastrop, TX
  • NPI 1588633499

  Endocrinology, Diabetes & Metabolism

  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104973171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 140494",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787140494",
            "telephone_number": "512-467-9444",
            "fax_number": "512-467-9550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3303 NORTHLAND DR",
            "address_2": "SUITE 308",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787314945",
            "telephone_number": "512-467-9444",
            "fax_number": "512-467-9550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL TEXAS PEDIATRIC ENDOCRINOLOGY AND DIABETES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WRAY",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "512-467-9444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D., PHD"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "TX",
            "license": "G4757",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS ID",
            "identifier": "0074KV",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Whole Child Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Central Texas Palliative Care Associates (Austin Palliative Care)
• Central Texas Pediatric Dentistry, PA
• Central Texas Pediatric Orthopedics and Scoliosis Surgery PA
• Central Texas Pediatric Orthopedics and Scoliosis Surgery PA
• Central Texas Physical Therapy LLC
• Central Texas Psychological Assessment, PLLC
• Central Texas Retina and Vitreous, P.a.

• Endocrinology, Diabetes & Metabolism Physician in Austin, TX
• Providers in Austin, TX by specialty
• Endocrinology, Diabetes & Metabolism Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.