Provider Demographics
NPI:1467323733
Name:TEQUA INTERNAL MEDICINE, PLLC
Entity type:Organization
Organization Name:TEQUA INTERNAL MEDICINE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TEQUA
Authorized Official - Middle Name:
Authorized Official - Last Name:SALEHI-RAD
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:602-898-7855
Mailing Address - Street 1:10613 N HAYDEN RD STE J108
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-5576
Mailing Address - Country:US
Mailing Address - Phone:602-898-7855
Mailing Address - Fax:602-898-4049
Practice Address - Street 1:10613 N HAYDEN RD STE J108
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-5576
Practice Address - Country:US
Practice Address - Phone:602-898-7855
Practice Address - Fax:602-898-4049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-17
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty