IndividualActive
Antonio Teague
NPI 1407540446 · Medical Physician Assistant · Mesa, AZ
Provider details
- NPI number
- 1407540446
- Entity type
- Individual
- Primary specialty
- Medical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Male
- Sole proprietor
- No
- License
- 10813 (AZ)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
143 S 63rd St Ste 100
Mesa, AZ 85206-1623
Phone: (480) 835-6100
Fax: (480) 461-4243
Approximate (ZIP-level) locationGet directions
Mailing address
6343 E Main St Ste 12
Mesa, AZ 85205-8955
Registry dates
- Enumerated
- 2023-06-05
- Last updated
- 2026-02-23
- Certified
- 2026-02-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.