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Search Term: 'physician fingerprint form'

CME - MD - NEW CME Requirements - Tab 5

“... were multiple bills passed requiring physicians, physician assistants and other licensees to complete certain specific opioid related continuing medical education.  These new CME requirements outlined above apply to the renewal of a license on or after September 1, 2020.     New ... ”

This content is located on the following page(s): Resources - CME for MD/DOs

Education

“This section of the physician profile contains the physician reported name, location and graduation date of all medical schools attended by the physician.   Also displayed is the physician reported graduate medical education taken in the US or Canada, including the following: Program name, Loca ... ”

This content is located on the following page(s): Physician Profile Descriptions

E-Prescribing Waiver

“... l condition; or before January 1, 2021.   A physician may apply for a waiver from the electronic prescribing requirement by: submitting a waiver request to the TMB and providing required information, and demonstrating circumstances necessitating a waiver from the requirement, including econo ... ”

This content is located on the following page(s): Renewal - Electronic Prescribing Waiver

Specialty Board Certification

“This section of the physician profile contains any physician reported specialty certifications issued by a board that is a member of the American Board of Medical Specialties or the Bureau of Osteopathic Specialists. ”

This content is located on the following page(s): Physician Profile Descriptions

Renewal Fingerprinting information

“Several types of licensees are required to submit their fingerprints for state and national criminal history background checks prior to renewal, per statutory requirements. Fingerprinting services are provided through IdentoGo by IDEMIA (formerly known as MorphoTrust USA, LLC) for a fee (see the Fin ... ”

This content is located on the following page(s): Renewals Physicians

Expert Consultants

“DIRECT DEPOSIT FORM 74-176 PAYEE CHANGE FORM 74-157 APPLICATION FOR TX ID NUMBER ”

This content is located on the following page(s): Expert Consultants

CE for AD Tab 2 - Exemptions

“... ; Acudetox Continuing Education Exemption Request Form

This content is located on the following page(s): CAE for Acudetox Specialists

Gold Designated Practice Status

“... andum of understanding with the patient's primary physician for treating and managing the patient           OR        If a clinic is currently certified by TMB as a Pain Management Clinic, the clinic must be operated by physicians who currently hol ... ”

This content is located on the following page(s): Gold Designated Practice

Physician Fingerprint FAQs

“... When do we have to do it? Can I complete the fingerprint requirement early? Can I get my fingerprints done anywhere? What is my Board issued 6-digit ID number? What if my Board issued ID number is only 5 digits long? What is the TMB “Service code” for IdentoGo? Why can&rsq ... ”

This content is located on the following page(s): Renewals Physicians

Continuing ED Tracking

“... , and report continuing education coursework. All PHYSICIAN, RESPIRATORY CARE PRACTITIONERS, ACUPUNCTURE, MEDICAL RADIOLOGIC TECHNOLOGISTS, ACUDETOX SPECIALISTS, MEDICAL PHYSICISTS AND SURGICAL ASSISTANTS licensees have access to establish a free, basic account with CE Broker. Beginning Ju ... ”

This content is located on the following page(s): Continuing ED Tracking

Title: NCT Instructor Application

Description:

Document: ... STRUCTIONS: Current Instructor s – This form MUST be completed, signed, dated, and notarized for each current instructor of a Non - Certified Program in medical radiologic technology s ubmitting an initial Instructor application to the Texas Board of Medical Radiologic ...

Click to view in browser - NCT Instructor Application 01.2025.pdf
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Title: Out of State Telemedicine Affidavit

Description: ... ostic testing and reporting of those results to a physician fully licensed and located in Texas, or (2) the follow-up of patients where the majority of patient care was rendered in another state.

Document: ... sti c testing and reporting of those results to a physician fully licensed and located in Texas, or (2) the follow - up of patients where the majority of patient care was rendered in another state. If the type of medicine you plan to practice under the Out - of - Sta te Telemedicine License does ...

Click to view in browser - Telemed_affidavit_FORMS.pdf
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Title: EMS Off-line Medical Director

Description: ... off-line medical director hard copy registration form

Document: 7 H[DV 0HGLFDO %oDUG 0DLOLQJ $GGUHVV 32 %o[  $XVWLQ 7H[DV  3KoQH  � ...

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Title: Form U - Actions and Investigations Section

Description: Yes response to any of the questions in the Actions and Investigations Section

Document: FORM U ______________________________________ ______________________ Applicant’s Signature Date _____________________________________________ Printed name LICENSURE APPLICATION FORM U ACTIONS/INVESTIGATIONS ...

Click to view in browser - Form U Professional Issues 01.2025.pdf
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Title: Form V - Medical Malpractice History

Description: Yes response to any of the questions in the Malpractice History Section.

Document: FORM V LICENSURE APPLICATION FORM V MALPRACTICE HISTORY Version 01.2025 “Yes” Response to Questions in Malpractice History /Professionalism Section You must complete a separa ...

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Title: Form W – Impairment Section

Description: Yes response to any of the questions in the Mental and Physical Health Section

Document: FORM W ______________________________________ ______________________ Applicant’s Signature Date _____________________________________________ Printed name LICENSURE APPLICATION FORM W IMPAIRMENT Version 0 4 .2020 “Yes” Response to ...

Click to view in browser - FORM W 04.2020.pdf
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Title: Form Y - Affidavit for Expedited Handling

Description: Form Y - Affidavit for Expedited Handling

Document: )250 < BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB BBBBBBBBBBBBBBBBBBBBBB $SSOLFDQW¶V 6LJQDWXUH 'DWH BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB 3ULQWHG QDPH /,&(1685( $33/,&$7,21 )250 < ± $)),'$9,7 )25 (;3(',7(' +$1'/,1* 9HUVLRQ  ...

Click to view in browser - FORM Y 2022.08.pdf
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Title: Medical Board 2025 - March - DPRC Committee Minutes

Description: Medical Board 2025 - March - DPRC Committee Minutes

Document: ... deration and approval of membership of the Expert Physician Panel. Dr. Bhatiamoved and Ms. Barnesseconded to grant the approval of appointments on the Expert Panel members list.The motion carried.Agenda Item #5.Discussion and Possible Action Regarding Review of Probationers’ AppearancesThere we ...

Click to view in browser - MB-2025-March-DPRC-Committee-Minutes.pdf
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Title: PA Board 2024 November - Full Board Minutes

Description: PA Board 2024 November - Full Board Minutes

Document: Texas Physician Assistant BoardBOARD MEETINGNovember 8The meeting was called to order on FridayNovember 8at a.m. byKarrie L Crosby, PAC, Presiding OfficerOther board members present were Melinda Gottschalk, PA Discussion, recommendation, and possible action regarding referralsAfter discussion, Mr. M ...

Click to view in browser - PA-2024-Nov-PA-Full-Board-Minutes.pdf
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Title: Physician Assistant Board Member List & Terms

Description: Physician Assistant Board Member Listing & Terms

Document: TEXAS PHYSICIAN ASSISTANT BOARD September 19, 2023 MEMBER TERM Rao K. Ali, M.D. September 19, 2023 – February 2025 Southlake (physician) Clayton “Clay” P. Bulls, PA - C . October 30, 2015 – February 1, 202 7 Abilene (physician as ...

Click to view in browser - PA Tenure list 9.19.2023.pdf
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Title: Press Release April 22, 2025-2

Description: TMB suspends McAllen physician (Haak)

Document: Texas Medical Board Press ReleaseFOR IMMEDIATE RELEASEApril, 202Media contact: communications@tmb.state.tx.usCustomer service: 5123057030 or 8004062 TMB suspendMcAllenphysicianOn April 17, 2025, a disciplinary panel of the Texas Medical Board temporarily suspended, without notice, the Texas medical ...

Click to view in browser - pr-20250422-2.pdf
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Title: Press Release April 22, 2025-3

Description: TMB suspends Houston physician (Adeyemo)

Document: Texas Medical Board Press ReleaseFOR IMMEDIATE RELEASEApril, 202Media contact: communications@tmb.state.tx.usCustomer service: 5123057030 or 8004062 TMB suspendHoustonphysicianOn April 17, 2025, a disciplinary panel of the Texas Medical Board temporarily suspended, without notice, the Texas medical ...

Click to view in browser - pr-20250422-3.pdf
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Title: Press Release April 3, 2015

Description: TMB suspends Sugar Land physician

Document: ... 800 - 248 - 4062 TMB suspends Sugar Land physician On April 2 , 2015 , a disciplinary panel of the Texas Medical Board temporarily suspended, with notice, the Texas medical license of Abraham K. Peringol , M.D., after determining his continuation in the practice of medicine po ...

Click to view in browser - pr-20150403.pdf
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Title: Medical Board 2014 - November - Full Board Minutes

Description: Medical Board 2014 - November - Full Board Minutes

Document: ... chools but two was met, as well as for all the Physician Assistant schools in Texas. Budget. Ms. Robinson gave a budget update. Legislative Update. Ms. Robinson gave a legislative update and reported staff will continue to monitor any legislation filed related to the agency. Au ...

Click to view in browser - MB-2014-Nov-Full-Board-Minutes.pdf
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Title: Medical Board 2015 - February - Disciplinary Process Review Committe Minutes

Description: Medical Board 2015 - February - Disciplinary Process Review Committe Minutes: Agenda Item 02 - TX PHP Report; Agenda Item 04 - TX Impaired Licensee Report; Agenda Item 08 - List of Potential Expert Panelists ; Agenda Item 12 - Legal Dismissals; Agenda Item 12 - Case List ...

Document: ... n regarding referrals and reports from the Texas Physician Health Program (PHP) . The Executive Director , Dr. John B. Fitzwater, presented the status of certain cases in PHP’s current caseload to the DPRC for possible referral back to the Board and requested guidance . Dr. G ...

Click to view in browser - MB-2015-Feb-DPRC-Minutes.pdf
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I didn’t receive my email renewal reminder.  How can I find that?

“... g them.  If you have any questions about the fingerprint requirements or the renewal process, please contact us at Registrations@tmb.state.tx.us. ”

Why can’t I find the IdentGo TMB “Service code” on the TMB website?

“TMB is not legally able to receive fingerprint results for individuals who are not existing applicants or licensees, and is not able to publicly provide the service code. This is why we provide the service code directly to licensees in the detailed instructions that are part of the email renewa ... ”

Can I complete the fingerprint requirement early?

“Yes, you can complete the fingerprint requirement at any point prior to your license expiration date. You do not need to wait for your expiration date. If you wish to submit your fingerprints early, please contact us at Registrations@tmb.state.tx.us and request your 6 digit ID number and i ... ”