Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Heather Renae Russon, PT, DPT

Individual provider Physical Therapist · NPI 1124630769

Heather Renae Russon, PT, DPT is a Physical Therapist in Private Practice in Cedar Park, Texas. Qualified in 2020, 6 years ago. Practices with Ideal Physical Therapy of Texas LLC, a 360-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
6
Licensed in
TX
In the registry since
2020
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

2519 S Lakeline Blvd Ste 100
Cedar Park, TX 78613-2964
Phone: (512) 331-6200
Fax: (512) 331-6384
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 1334406 (TX)

Record details

NPI number1124630769
Entity typeIndividual (Type 1)
GenderFemale
Credentials PT , DPT
Sole proprietorNo
NPI enumeratedAugust 17, 2020
Last updated in NPPESNovember 26, 2024
Certification dateNovember 26, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Ideal Physical Therapy Of Texas Llc — 360 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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