MEDICARE: RIANE TEAGARDEN DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	POD.0000895	CO
2	213E00000X	Podiatrist	POD457	NM

General Provider Information

NPI Number	:	1952894305
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RIANE TEAGARDEN DPM

Provider Business Mailing Address
First Line	:	8080 ACADEMY RD NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87111-1111
Country	:	US
Telephone Number	:	505-247-4164
Fax Number	:	505-247-4561

Provider Business Practice Location Address
First Line	:	435 SAINT MICHAELS DR STE B203
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87505-7681
Country	:	US
Telephone Number	:	505-372-7499
Fax Number	:	505-247-4561

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/11/2018
Last Update Date	:	10/18/2023

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Directions to “ RIANE TEAGARDEN DPM” Practice Location

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