=====================================================
General NPI Number Information
=====================================================
NPI Number | 1225971773
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KPH-CONSOLIDATION, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/10/2026
-----------------------------------------------------
Last Update Date | 04/10/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1103 E HOUSTON ST
-----------------------------------------------------
City | CLEVELAND
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77327-4670
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-593-8350
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1103 E HOUSTON ST
-----------------------------------------------------
City | CLEVELAND
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77327-4670
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | JOHN CORBEIL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 281-348-8011
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QE0002X
-----------------------------------------------------
Taxonomy Name | Emergency Care Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------