Texas

At a Glance

Category	Details
IMLC Member	Yes
FCVS	Accepted
NP Independent Practice	No
PA Independent Practice	No
Physician-Owned PC Allowed	Yes
Max NPs per Physician	7
Max PAs per Physician	7

Licensure

Item	Cost
Initial License	$817
Renewal Fee	$500
Renewal Cycle	Biennial
Annualized Cost	$250
Controlled Substance Registration	No

Endorsement & Reciprocity

Not yet researched — whether this state offers license-by-endorsement or reciprocity, and its prerequisites, is being verified.

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APC Supervision

In-state requirement for supervising physicians: MD must be licensed in TX; monthly meetings.

Nurse Practitioners

NPs require physician supervision in Texas.

• Maximum NPs per physician: 7

Physician Assistants

PAs require physician supervision in Texas.

• Maximum PAs per physician: 7

Additional Notes

Combined max of 7.

CME & Training Requirements

Requirement	Details
Total CME	48 hours
Category 1 Minimum	24 hours
Cycle	Biennial
Ethics / Jurisprudence	2 hrs/cycle
Pain Management	2 hrs/cycle
Human Trafficking	1 hr one-time
DEA MATE Act	8 hrs one-time (federal)
Jurisprudence Exam	Required

Fingerprint Requirements

Detail	Info
Required	Yes
FBI Check	Unknown
Method	IdentoGO
Out-of-State Options	Contact board

Malpractice Insurance

• Required for licensure/practice: No
• Applies to: TMB itself states there is no statutory mandate; malpractice insurance is instead commonly required as a condition of hospital privileges, not licensure.

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Giving Up a License

• Status after lapse: expired, with a 30-day grace period; automatically cancelled if expired one year or longer
• Lapse consequences: Escalating delinquent-registration penalty fees ($75 after the 30-day grace period, $150 after 90 days) apply on top of the registration fee; after one year expired, the license is automatically cancelled (not merely lapsed) and presumably requires new licensure.
• Voluntary surrender: Available — TMB offers a formal non-disciplinary 'Retirement' status (and 'Emeritus Retirement' subtype) that a physician can request; eligibility explicitly requires the license NOT be under investigation, under Board order, or otherwise restricted — distinct from the disciplinary 'voluntary surrender' under Occupations Code §164.061 (Chapter 164, Board's enforcement authority).
• Reinstatement: To return to practice from retired or emeritus-retired status, a physician must submit an online application for re-activation/re-licensure and meet all current licensure requirements (registration fees already paid are not refundable).
• Exit in good standing: Available — TMB's 'Emeritus Retirement' status is explicitly reserved for physicians with a clean disciplinary and criminal record — a board-attestable good-standing exit distinct from ordinary retirement.

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Quirks & Gotchas

Fees

• Application fee: $867** (as of 9/1/2025) — includes the Jurisprudence Exam fee
• NPDB/HIDB surcharge: $21** — non-refundable, always
• Texas Physician Health Program surcharge: $7** — non-refundable, always
• IdentoGo fingerprint processing fee** — paid directly to IDEMIA, separate from TMB fees
• FCVS/FCSA fees** — borne by applicant; required for IMGs using credential verification services
• Temporary license: free** — issued via affidavit while full license processes
• Refunds are allowed on the $867 base fee under limited circumstances, but surcharges ($28) are never refundable
• Active-duty military can get the full fee waived (surcharges still apply)

Application Requirements

• Stage 1 (Pre-Licensure/Screening): Applicant uploads documents; TMB screens eligibility. Completion of Stage 1 does not** guarantee licensure.
• Stage 2 (Licensing): Assigned to a licensing analyst. License issued on a twice-monthly schedule** — missing the cycle means waiting another 2 weeks.
• After license issuance, registration is required within 2 weeks via a separate letter/email process. Missing this has its own penalty exposure.
• The LIST portal (License Inquiry System of Texas) is the primary communication channel. Applicants must monitor the “Lacking Reasons” tab proactively — TMB does not always push notifications. Allow 3–5 business days per response.

Jurisprudence Exam

• Required** for all physician applicants and all IMLC licensees
• Fee: included in $867 application fee
• Unlimited attempts, no per-attempt cost
• Accessed only through a MyTMB account (separate from the LIST application account — you need both)
• Study guide is online-only — cannot be printed or downloaded
• Best taken on Chrome or Firefox on PC/Mac
• If your Texas license was previously cancelled and you reapply, you must retake the exam
• IMLC licensees: JP exam must be passed within 90 days of license issuance or penalty fees apply
• TMB sends no notification of pass/fail — you must log in and check yourself

Fingerprints & Background Check

• Processed through IdentoGo by IDEMIA — applicant schedules and pays directly
• Required for both state and national criminal history checks
• Must be completed before licensure can be finalized

Other Gotchas

• IMLC applications are submitted via imlcc.com, not the TMB website
• $867 IMLC processing fee** — non-refundable except for active-duty military (refund request within 90 days of issuance)
• Board certification is mandatory for IMLC eligibility (ABMS or AOABOS) — not required for the standard full license route
• Each USMLE/COMLEX component must have been passed in 3 or fewer attempts — hard cutoff
• Must hold a full, unrestricted license in a Compact state that is your State of Principal License (SPL)
• After TMB issues the IMLC license, there is a hard 90-day window to complete ALL of:
• Missing the 90-day window triggers penalty fees
• Citizenship/lawful presence document processing time is undefined; applicants are told to “check back often” — build in extra lead time
• Cannot have an existing active traditional TMB application running simultaneously** — must withdraw first before applying via IMLC
• After issuance, IMLC website takes 5–7 business days to reflect the Texas license; e-Permits take 2 business days post-registration
• Must meet one of: ABMS/BOS board certification, graduation from a “Substantial Equivalent” list school, or FCSA equivalency evaluation
• Alternative pathway: 5 years unrestricted full U.S. license without disciplinary action (avoids credential evaluation)
• FCSA evaluation fees are entirely separate from TMB fees
• Licenses issued twice monthly on a published schedule — plan around it to avoid practice gaps
• Address changes must be made only through the MyTMB portal — phone notification is not accepted and not recorded
• Name changes require legal documentation and professional use of the licensed name; a separate application form is required
• Uniform Application (FSMB) reduces paperwork redundancy but does not replace the TMB online application — you still must file both
• Full Texas Medical License Application | Texas Medical Board
• Interstate Medical Licensure Compact Application | Texas Medical Board
• Continuing Education Requirements for Physicians | Texas Medical Board
• Jurisprudence Exam | Texas Medical Board
• Texas Medical License: How to Apply and Meet State Requirements | medicallicensing.com
• Texas Medical License | White Glove Licensing Researched from state board websites and regulatory sources. Verify with the board directly before applying.

CME & Mandatory Training

| Mandatory Topic | Hours | Frequency | | Medical Ethics / Professional Responsibility | 2 formal | Every 24 months | | Pain Management & Opioid Prescribing | 2 formal | Within 1 year of initial licensure; then every 8 years | | Human Trafficking — Identification & Assistance | 1 formal | First renewal, then every 6 years | | Forensic Evidence Collection (new, eff. 9/1/2026) | 2 formal | Applies to ER/forensic exam physicians | | Obstetric Emergencies — Life of the Mother Act | 1 formal, one-time | Physicians providing OB care only; taken via MyTMB |

• Ethics and pain management hours cannot be carried over** to the next renewal cycle
• Maximum 48 hours can carry forward otherwise (within 2 years of completion)
• Pain clinics: 10 hours pain management CME per biennial cycle
• EMS Medical Directors: 12 hours initial training within 2 years, then 1 hour per renewal
• All TMB licensees must have a CE Broker account; TMB will only accept CE verification through CE Broker
• Courses logged under another state’s license in CE Broker do not automatically transfer to Texas — must be re-logged for Texas
• Failure to have CE Broker-verified compliance will block renewal
• Currently optional (audit-based); becomes mandatory at renewal on/after 9/1/2026

Lawful Presence / Citizenship Requirement

• Texas treats a medical license as a “public benefit” under 8 U.S.C. § 1621
• Proof of lawful presence must be unexpired on the date of issuance and each renewal
• Applications remain pending — not denied — while documents are being processed, but timeline is open-ended

Exam Requirements

• Maximum 3 total attempts on any single licensing exam component (USMLE, COMLEX, FLEX, NBME, etc.)
• Hard limit; exceptions exist but require Board review

Resources

• Texas Medical Board
• FSMB State Licensure Directory
• Interstate Medical Licensure Compact

Sources

Data compiled from state medical board websites, FSMB, and regulatory filings.

Have a correction or update? Let us know.