Koral Charles, RBT

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

RBT-17-28400 Issued in TX

Practice address

170 Deep Wood Dr Ste 104
Round Rock, TX 78681-4949

Phone

(512) 910-3251

NPI assigned

Apr 10, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1586476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588118400000",
    "number": "1942829809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 DEEP WOOD DR STE 104",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786814949",
            "telephone_number": "512-910-3251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 DEEP WOOD DR STE 104",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786814949",
            "telephone_number": "512-910-3251"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "920 Highway 352 Ste 200",
            "address_purpose": "LOCATION",
            "city": "Mesquite",
            "state": "TX",
            "postal_code": "751496806",
            "country_code": "US",
            "telephone_number": "469-828-8248",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHARLES",
        "first_name": "KORAL",
        "credential": "RBT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-10",
        "last_updated": "2020-04-29",
        "certification_date": "2020-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "TX",
            "license": "RBT-17-28400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BACB",
            "identifier": "RBT-17-28400",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jia Wen Jessica Chang, M.D.
• Brenda Ru-Lan Chao, M.D.
• Priscilla Chapa
• Louise Jane Chaplin, LPC
• Dennis Ray Chapman, LCSW
• Marcus Charles
• Chartwell Community Services, Inc.
• Charu Sawhney DO MPH
• Saswati Chaudhury, M.D
• Angela Chavando, COTA

• Behavior Technician in Round Rock, TX
• Providers in Round Rock, TX by specialty
• Behavior Technician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.