| Organization Name: | CHUDLEIGH, PA |
| NPI Number: | 1003295429 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JAMES C CHUDLEIGH (MEDICAL DIRECTOR) |
| Mailing Address: | 3724 Executive Center Dr Ste 230 Austin |
| State: | TX US |
| Postal Code: | 787311646 |
| Phone Number: | 5124522100 |
| Fax Number: | 8554567410 |
| NPI Enumeration Date: | 05/19/2015 |
| NPI Last Update Date: | 05/19/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 364SG0600X |
| License Number: | F1450 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Clinical Nurse Specialist |
| Taxonomy Specialization: | Gerontology |
| Taxonomy Definition: | |