Healthcare Provider Details

I. General information

NPI: 1861819864
Provider Name (Legal Business Name): TYLER ROBERT MCCLINTOCK M.D., M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2014
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

911 W 38TH ST STE 200
AUSTIN TX
78705-1107
US

IV. Provider business mailing address

911 W 38TH ST STE 200
AUSTIN TX
78705-1107
US

V. Phone/Fax

Practice location:
  • Phone: 512-451-7935
  • Fax: 512-451-7965
Mailing address:
  • Phone: 512-451-7935
  • Fax: 512-451-7965

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberT0859
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: