Individual
DR. ROGER A RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1049 N 3RD ST, STE 505, ABILENE, TX 79601-5833
(325) 672-8883
(325) 675-5833
Mailing address
1049 N 3RD ST, STE 505, ABILENE, TX 79601-5833
(325) 672-8883
(325) 675-5833
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2-2996
TX
106H00000X
Marriage & Family Therapist
873LMFT
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0971830-01
—
TX
Enumeration date
08/04/2005
Last updated
01/19/2012
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