=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851204366
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KCA GLOBAL BUSINESS LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/25/2026
-----------------------------------------------------
Last Update Date | 09/25/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 17878 PRESTON RD APT 201
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75252-5605
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-899-7167
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 17878 PRESTON RD APT 201
-----------------------------------------------------
City | DALLAS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75252-5605
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-899-7167
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MR. CORVIN KOFFI AHISSOU JR.
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 317-332-5271
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 343900000X
-----------------------------------------------------
Taxonomy Name | Non-emergency Medical Transport (VAN)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------