Provider Demographics
NPI:1861128555
Name:TRIAD COMPLETE WOMENS HEALTHCARE, LLC
Entity type:Organization
Organization Name:TRIAD COMPLETE WOMENS HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:BINTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-270-7929
Mailing Address - Street 1:2703 N 14TH STREET
Mailing Address - Street 2:
Mailing Address - City:PONCA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:74601
Mailing Address - Country:US
Mailing Address - Phone:580-765-9451
Mailing Address - Fax:
Practice Address - Street 1:802 E MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:STIGLER
Practice Address - State:OK
Practice Address - Zip Code:74462-2772
Practice Address - Country:US
Practice Address - Phone:580-749-7846
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-26
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty