LTC Support Services PLLC

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

License

F1450 Issued in TX

Legal business name

LTC SUPPORT SERVICES PLLC

Practice address

7620 Deer Run
Leander, TX 78641

Phone

(512) 699-8819

NPI assigned

Jun 27, 2017

Organization subpart

No

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

Authorized official

Name

Dr. James Painter Chudleigh Jr., MD

Title

Owner

Phone

(512) 699-8819

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1498521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1609396928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7620 DEER RUN",
            "city": "LEANDER",
            "state": "TX",
            "postal_code": "786416108",
            "telephone_number": "512-699-8819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7620 DEER RUN",
            "city": "LEANDER",
            "state": "TX",
            "postal_code": "78641",
            "telephone_number": "512-699-8819"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1501 S Main St",
            "address_purpose": "LOCATION",
            "city": "Lockhart",
            "state": "TX",
            "postal_code": "786443945",
            "country_code": "US",
            "telephone_number": "512-699-8819",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LTC SUPPORT SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-27",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "CHUDLEIGH",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "PAINTER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "512-699-8819",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "TX",
            "license": "F1450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "173205901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dulce Lopez
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• Timothy A Mack, APRN
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• Geriatric Medicine (Family Medicine) Physician in Leander, TX
• Providers in Leander, TX by specialty
• Geriatric Medicine (Family Medicine) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.