In short, you may not need a referral to seek PT services in Texas. 

Direct access laws exist in Texas that allow you to begin PT without a referral. However, if you continue PT beyond 10 business days a signed plan of care or referral is warranted (15 days for those with a residency, fellowship, or board specialty certification). 

A plan of care or referral can come from your physician, chiropractor, PA, APRN, or dentist. 

The caveat to this is if you chose to use insurance and what your insurance requires. Medicare, for example, requires a referral prior to starting PT. 

The goal of direct access is to allow for patients to be seen quicker (saving time and money), and with less hoops to jump through – two things I believe most of us would say our healthcare system needs.