Texas

Licensure

• Board: Texas Medical Board (TMB)
• Application: Online via TMB portal
• Requirements: USMLE/COMLEX, residency completion, background check, jurisprudence exam
• Timeline: 4-8 weeks typical processing
• Fees: ~$900 initial application
• Renewal: Biennial, birth month
• Interstate Compact: Texas is an IMLC member state

Telehealth

• Texas allows telehealth across all modalities (audio, video, asynchronous)
• Established patient relationship required for prescribing controlled substances
• Out-of-state physicians must hold a Texas license or qualify under IMLC
• No separate telehealth registration required

Friendly PC

• Texas has a corporate practice of medicine doctrine — only licensed physicians can own medical practices
• Friendly PC structures are common — a physician holds nominal ownership while an MSO handles business operations
• MSO agreements must be carefully structured to avoid violating the doctrine
• PE-backed practices frequently use this model in Texas
• TMB has not aggressively enforced against well-structured Friendly PCs, but the legal risk exists

APC Supervision

• NPs: Texas requires a collaborative/supervisory agreement with a physician. NPs cannot practice independently.
• PAs: Must have a supervisory agreement with a physician. Supervision can be remote but must be available for consultation.
• Supervision ratios: Physicians may supervise up to 7 PAs/NPs at any time (combined)
• Prescriptive authority: NPs and PAs can prescribe with delegation, including Schedule III-V controlled substances. Schedule II requires additional protocols.