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Individual
TYNAN S. MCCLOSKEY
Active
Individual
TYNAN S. MCCLOSKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA05423
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1710158092
TRICARE
OH
01
—
1710158092
TRICARE SOUTH
TX
05
—
192684202
—
TX
05
—
192684203
—
TX
01
—
8Y9631
BXBS TEXAS
TX
01
—
8Y9632
BCBSTX
TX
Enumeration date
03/14/2008
Last updated
09/16/2021
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