Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Travis Odell Russell Jr., PTA

Individual provider Physical Therapy Assistant · NPI 1720568819

Travis Odell Russell Jr., PTA is a Physical Therapy Assistant in Fort Worth, Texas. Practices as a sole proprietor. Licensed in Texas.

Licensed in
TX
In the registry since
2018
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

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Practice location Address checks out

3600 Angle Ave
Fort Worth, TX 76106-3559
Phone: (817) 624-6164
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 2035186 (TX)

Record details

NPI number1720568819
Entity typeIndividual (Type 1)
GenderMale
Credentials PTA
Sole proprietorYes
NPI enumeratedAugust 17, 2018
Last updated in NPPESAugust 17, 2018

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