MEDICARE: KPH-CONSOLIDATION, INC.

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	261QE0002X	Emergency Care Clinic/Center

General Provider Information

NPI Number	:	1336082874
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KPH-CONSOLIDATION, INC.

Provider Business Mailing Address
First Line	:	9711 N SAM HOUSTON PKWY E
Second Line	:
City	:	HUMBLE
State	:	TX
Zip	:	77396-4482
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9711 N SAM HOUSTON PKWY E
Second Line	:
City	:	HUMBLE
State	:	TX
Zip	:	77396-4482
Country	:	US
Telephone Number	:	281-441-6520
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JOHN CORBEIL
Credential	:
Telephone Number	:	281-348-8011

Provider Enumeration Date	:	04/10/2026
Last Update Date	:	04/10/2026

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