# PERSONAL HEALTH ASSESSMENT

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

## Provider details

- **NPI number:** 1356846307
- **Authorized official:** ROY BRIAN KUPPENBENDER (FOUNDER)
- **Authorized official phone:** (866) 410-7422

## Contact information

- **Practice address:** 18320 MICHAEL ANGELO DRIVE, DALLAS, TX 75287
- **Practice address phone:** (866) 410-7422
- **Mailing address:** 18320 MICHAEL ANGELO, DALLAS, TX 75287
- **Mailing address phone:** (866) 410-7422

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RC0001X | Clinical Cardiac Electrophysiology Physician | — | TX | Yes |

## Other

- **Enumeration date:** 03/29/2018
- **Last updated:** 07/21/2022