# TRIAD COMPLETE HEALTHCARE Z16 LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144014176
- **Authorized official:** MATTHEW BINTZ (PRESIDENT)
- **Authorized official phone:** (970) 270-7929

## Contact information

- **Practice address:** 2703 N 14TH ST, PONCA CITY, OK 74601-1738
- **Practice address phone:** (580) 749-7846
- **Mailing address:** 2703 N 14TH ST, PONCA CITY, OK 74601-1738
- **Mailing address phone:** (580) 749-7846

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 04/07/2025
- **Last updated:** 04/07/2025