Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Antonio Teague

Individual provider Medical Physician Assistant · NPI 1407540446

Mr. Antonio Teague is a Physician Assistant in Mesa, Arizona. Qualified in 2024, 2 years ago. Licensed in Arizona.

Years since qualifying
2
Licensed in
AZ
In the registry since
2023

Practice location Address checks out

143 S 63rd St Ste 100
Mesa, AZ 85206-1623
Phone: (480) 835-6100
Fax: (480) 461-4243
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 10813 (AZ)

Record details

NPI number1407540446
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJune 5, 2023
Last updated in NPPESFebruary 23, 2026
Certification dateFebruary 23, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Mesa