Organization
LTC SUPPORT SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES PAINTER CHUDLEIGH JR. MD (OWNER)
(512) 699-8819
Entity
Organization
Contact information
Practice address
7620 DEER RUN, LEANDER, TX 78641
(512) 699-8819
Mailing address
7620 DEER RUN, LEANDER, TX 78641-6108
(512) 699-8819
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
F1450
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
173205901
—
TX
Enumeration date
06/27/2017
Last updated
07/21/2022
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