Provider Demographics
NPI:1427542513
Name:MCALLISTER, TYLER SHANE (DPM)
Entity Type:Individual
Prefix:DR
First Name:TYLER
Middle Name:SHANE
Last Name:MCALLISTER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 ALBERON GARDENS WAY
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89002-3367
Mailing Address - Country:US
Mailing Address - Phone:702-526-0609
Mailing Address - Fax:
Practice Address - Street 1:2950 E FLAMINGO RD STE A
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-5208
Practice Address - Country:US
Practice Address - Phone:702-731-3338
Practice Address - Fax:702-731-3341
Is Sole Proprietor?:No
Enumeration Date:2018-06-21
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV2071213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery