- My TMB |
- Contact Us |
-
-
“... subscription by clicking the link provided in the registration confirmation email.
Please add our domain “@tmb.state.tx.us” to your safe senders list to prevent our updates from being filtered as spam.
Join Our E-Mail List
Email:
... ”
“... sp;
Sincerely,
Rhea Hines, Director
Registration Department
Licensure Credential Verification Process Letter(PDF) Version
”
“... all vital events operations, including reporting, registration, and amendments of births and death records.
To register for electronic filing, follow this link to TxEVER: https://txever.dshs.texas.gov/TxEverUI/Welcome.htm and click on “User Enrollment”
If you have problems register ... ”
“... physicians, and if prescribing drugs, must have a prescriptive delegation agreement with their supervising physician(s).
The Licensure Department of the Texas Physician Assistant Board is committed to furthering the mission of the Board by ensuring quality healthcare for the citizens of Texas ... ”
“... ulating the practice of medicine in Texas through registration of physicians; determining a physician’s eligibility for licensure; conducting investigations based on complaints filed against physicians; and exercising authority to cancel, revoke, suspend, or otherwise limit the license of any ... ”
“... nbsp;| PDF | Word
Chapter 156 -
Registration of Physicians: HTML | PDF | Word
Chapter 157 -
Authority of Physician to Delegate Certain Medical Acts: HTML | PDF | Word
Chapter 158 -
Authority of Physician to Provide Certain Drugs ... ”
“The Texas Occupations Code (see Laws/Practice Acts) and Board Rules authorize the Texas Medical Board to approve and certify two types of health organizations which meet certain strict criteria. Both types of nonprofit health organizations must keep TMB informed of changes in their by-laws ... ”
“
The Pre-Licensure, Registration and Consumer Services (PRC) responds to requests for verifications of licenses. PRC Representatives are also trained to answer general questions regarding licensure, registration and continuing education.
Phone: (512) 305-7030
Fax: (512) 463-9416 or (888) 790-0 ... ”
“... ontrolled substances, or delegate medical acts or prescriptive authority.
Provisional License is available only to applicants for a full medical license and allows the applicant to practice for 270 days in a medically underserved or health professionals shortage area.
Medical License Limited to Unde ... ”
“... s no longer required so please make sure your DEA registration remains active at all times.
Apply online ”
“... t member of the National Council of Architectural Registration Boards. She most recently completed two years of service on the Board of Directors at the Texas State Affordable Housing Corporation. Shipley received a Bachelor of Science in Entrepreneurship from Grove City College and a Master of Arch ... ”
“... regulating physician assistants in Texas through registration; determining physician assistants’ eligibility for licensure; conducting investigations based on complaints filed against physician assistants to determine if a licensee is in violation the Texas Occupations Code (Chapter ... ”
“... r the first time, you need to pay your first time registration fee within 90 days of your license issue date. To maintain an active license, you will need to renew your registration biennially.
For any questions related to the renewal, please contact us at Registrations@tmb.state.tx.us using t ... ”
“... ncellation.
Please note: You must complete registration and pay the fee within 90 days of the date your license was issued to avoid penalty fees. If you have not registered your license within 90 days of your license issue date, a penalty fee equal to ½ the registration fee will ... ”
“
As of 9/1/2023, he biennial registration fee includes the $13.48 Prescription Monitoring Program (PMP) fee, $5.25 for the Physician Health Program (PHP) and a $2 Office of Patient Protection fee. These fees are required by statute. The remaining $535 is the fee required by the TMB.
The ... ”
Description: Rule Changes May 05, 2011
Document: ... AMINING%20BOA RDS.html#197 CHAPTER 166. PHYSICIAN REGISTRATION 22 TAC §166.7 The Texas Medical Board (Board) adopts new §166.7, concerning Report of Impairment on Registration Form. The new section provides that if a licensee has an impairment that affects a licensee's ability to actively practice m ...
Description: Rule Changes May 02, 2010
Document: ... vailable until the patient is discharged; §192.4, Registration, excludes Level I services from registration requirements and deletes languages relating to pain management clinics; §192.5, Inspections; repeal §192.7, Operation of Pain Management Clinics. http://www.sos.state.tx.us/texreg/archive/Apri ...
Description: Rule Changes March 04, 1998
Document: ... ssed within seven years. Chapter 166.2, Physician Registration amendment which will clarify that continuing medical education courses recognized by the Committee for Review and Recognition of the Accreditation Council for Continuing Medical Education and sponsored by state medical societies, meet th ...
Description: Rule Changes March 05, 2000
Document: ... e fee and application for office-based anesthesia registration.
Description: Rule Changes March 05, 2000
Document: ... e fee and application for office-based anesthesia registration.
Description: Rule Changes March 08, 2001
Document: ... fficient reports, and fees. Chapter 193, Standing Delegation Orders - proposed amendment to 193.6(h) to correct a cite to the Texas Occupations Code Annotated.
Description: Rule Changes March 06, 2003
Document: ... al clean-up of the chapter. Chapter 193, Standing Delegation Orders. Amendments to '193.6 regarding supervision waiver requests.
Description: Rule Changes April 16, 2008
Document: ... y to other staff members,. Chapter 166, Physician Registration, amending 166.4 Expired Registration Permits, Interprets §156.005, Occ. Code, as providing an exclusive penalty for practicing medicine after the expiration of a permit and within one year. Chapter 167, Reinstatement and Reissuance, in a ...
Description: Rule Changes May 01, 2006
Document: ... hapter 175, Fees, Penalties, and Forms. Increased registration fees for Physician Assistants. Chapter 183, Acupuncture. Amendments adds a more extensive list of functions of the Acupuncture board; update the citation to the board rule regarding licensure; delete references to provision of 183.4(g) t ...
Description: Rule Changes January 25, 2006
Document: ... quality of care violations. Chapter 193, Standing Delegation Orders. Amendments delete the reference to registration of delegation of prescriptive authority with the Board; set out rules requiring a physician who delegates prescriptive authority to document when and to whom a delegation is made; and ...
Description: Rule Changes January 22, 2009
Document: ... erred to another physician. Chapter 166 Physician Registration, amending 166.2, Continuing Medical Education, updates the word "hours" to "credits" to comport with modern language usage and 166.6, Exemption from Registration Fee for Retired Physician Providing Voluntary Charity Care, updates the wor ...
Description: Rule Changes January 09, 2005
Document: ... sician Assistant Students. Chapter 166, Physician Registration: Rule review and amendments to §166.1 relating to licensees notifying board of changes in professional names. Chapter 172, Temporary Licenses: Amendments to §172.10 relating to Department of State Health Services (DSHS) Medically Underse ...
Description: Rule Changes January 08, 2004
Document: ... es to the text of the rule. Chapter 193, Standing Delegation Orders. Amendments to §193.6 concerning the procedure for considering waiver requests for prescriptive delegation. Chapter 194, Non-Certified Radiologic Technicians. Amendments to §§194.1194.4, and 194.6; the repeal of §§194.7-194.10 and n ...
Description: Rule Changes January 06, 2002
Document: ... pedited licensure process. Chapter 166, Physician Registration. Rule review and proposed amendments to 166.1-166.6 regarding general cleanup, CME temporary licenses, SB1300 (30-day grace period to practice with an expired permit) and voluntary charity care provided to indigent populations. Chapter 1 ...
Description: Rule Changes January 02, 2013
Document: ... ent to §190.8 provides the standard for physician delegation of the performance of nerve conduction studies by individuals who are not licensed as physicians or physical therapists. The amendment to §190.14 amends the range and scope of sanctions for violations of the Medical Practice Act. CHAPTER 1 ...
“In a long term care facility based practice, delegation is by the medical director. ”
Who may delegate prescriptive authority in a long term care facility based practice?
In a long term care facility based practice, delegation is by the medical director.
“... d circumstances a physician who issues a standing delegation under chapter 203 generally “is not liable in connection with an act performed under that standing delegation order”). Thus, we cannot conclude that the liability of a physician delegating the administration of anesthesia to a ... ”
Are physicians potentially subject to discipline for violations of the standard of care by CRNAs to whom they have delegated the selection or administration of anesthesia or the care of an anesthetized patient?
Yes, potentially. Although physicians are not required to supervise CRNA’s for delegated tasks, they nonetheless remain subject to potential liability for violations of the standard of care by CRNAs, depending on federal and state statutes and regulations. The degree to which a physician is required to supervise a CRNA during the performance of a task in anesthesia services is left to the “physician’s professional judgment in light of other relevant federal and state laws, facility policies, medical staff bylaws, and ethical standards.” (Texas Attorney General Opinion No. JC-0117). However, physician supervision during the medical management of a patient while undergoing an anesthetic may require supervision dependent on federal and state statutes and regulations.
Additionally, Texas Attorney General Opinion No. KP-0353 found “In authorizing physicians to delegate the administration of anesthesia to CRNAs, the Legislature did not expressly limit the liability of the delegating physician. See TEX. OCC. CODE § 157.058; cf. id. § 157.004(c) (providing that in specified circumstances a physician who issues a standing delegation under chapter 203 generally “is not liable in connection with an act performed under that standing delegation order”). Thus, we cannot conclude that the liability of a physician delegating the administration of anesthesia to a CRNA is limited solely to the determination of competency. Questions of physician liability in any specific context are highly factual and not an appropriate determination for the opinion process. See Tex. Att’y Gen. Op. No. GA-0446 (2006) at 18 (“Questions of fact are not appropriate to the opinion process.”) (Page 4 with emphasis added.)
“... eral and state statutes and regulations regarding delegation. The physician retains responsibility of the medical management of the patient. Therefore, the delegating physician must consider the delegatee’s education, training, and experience prior to delegating. Additionally ... ”
When is Physician supervision of a CRNA required?
Regardless of the circumstances when supervision is or is not required, it is important to remember that the delegating physician must abide by all required federal and state statutes and regulations regarding delegation. The physician retains responsibility of the medical management of the patient. Therefore, the delegating physician must consider the delegatee’s education, training, and experience prior to delegating. Additionally, delegation may be revoked by the delegating physician at any time.
The Texas Attorney General has issued three opinions on CRNA supervision. The latest opinion found that although physician supervision of a CRNA is not required in Texas Occupations Code Sec. 157.058, other federal and state statutes and regulations may require physician supervision of a CRNA, a CRNA may not administer an anesthetic that is a controlled substance outside the presence of a physician, and the Legislature did not expressly limit the liability of the delegating physician.
Specifically, Texas Attorney General Opinion KP-0353 found “Section 157.058 of the Occupations Code does not, by itself, require a physician who properly delegates anesthesia-related tasks to a certified registered nurse anesthetist (“CRNA”) to supervise the performance of those acts.” (Page 5)
However, KP-0353 also found “…the language of chapter 157 is not the only relevant authority to consider in addressing the question of physician supervision over acts delegated to a CRNA. Federal regulations limiting Medicare coverage and conditioning hospital participation in Medicare and Medicaid programs require physician supervision of a CRNA when administering anesthesia in certain circumstances. See, e.g., 42 C.F.R. §§ 416.42(b)(2), 482.52(a)(4), 485.639(c)(1)(v), (2) (requiring a CRNA to operate under a physician’s supervision when administering anesthesia in certain circumstances). Furthermore, a CRNA may not administer an anesthetic that is a controlled substance outside the presence of a physician. See TEX. HEALTH & SAFETY CODE §§ 481.002(1)(A) (defining “administer” to require agent to apply controlled substance in presence of physician), .071(a) (prohibiting physician from causing controlled substance to be administered under physician’s “direction and supervision” except for valid medical purpose and in course of medical practice). And a CRNA may not obtain an anesthetic that is a dangerous drug unless a physician has listed that CRNA as the physician’s designated agent. See id. §§ 483.001(4) (defining “designated agent”), .022(a) (requiring physician to name each designated agent in writing). (Page 3 with emphasis added.)
Finally, KP-0353 found “Whether and the extent to which physician supervision is required for an act delegated to a CRNA will depend on the specific act delegated, the type of facility in which the CRNA performs the act, and any relevant regulations of that facility. And while section 157.058 authorizes a physician to delegate to a CRNA, a physician is never required to do so. If a physician is concerned about a CRNA’s ability to perform a delegated act or desires to limit the delegation, the physician retains the authority to refrain from delegating, to limit the delegation, or to supervise the delegation to whatever extent the physician determines necessary. In sum, the authority to delegate provided by section 157.058 of the Occupations Code does not eliminate the need to comply with all other applicable statutes, regulations, bylaws, ethical standards, and a physician’s own professional judgment. See TEX. OCC. CODE § 157.007 (“An act delegated by a physician under [chapter 157] must comply with other applicable laws.”). (Page 4 with emphasis added.)
“APRNs or PAs may prescribe schedule II drugs in the following situations: (1) in a hospital facility-based practice, in accordance with policies approved by the hospital's medical staff or a committee of the hospital's medical staff as provided by the hospital's bylaws to ensure patient safety ... ”
Who can prescribe Schedule II drugs under physician delegation?
APRNs or PAs may prescribe schedule II drugs in the following situations:
(1) in a hospital facility-based practice, in accordance with policies approved by the hospital's medical staff or a committee of the hospital's medical staff as provided by the hospital's bylaws to ensure patient safety and as part of care provided to a patient who:
(A) has been admitted to the hospital for an intended length of stay of 24 hours or greater; or
(B) is receiving services in the emergency department of the hospital; or
(2) as part of the plan of care for the treatment of a person who has executed a written certification of a terminal illness, has elected to receive hospice care, and is receiving hospice treatment from a qualified hospice provider.
“... pital anddoes not qualify as an eligible site for delegation of schedule II authority. The physician may only delegate authority to prescribe controlled substances in schedules III through V in this setting. Authority to prescribe dangerous drugs, nonprescription drugs and devices may be ... ”
Can schedule II authority be delegated in a free standing emergency department that is affiliated with a hospital?
No. A free standing emergency department is not located within the hospital anddoes not qualify as an eligible site for delegation of schedule II authority. The physician may only delegate authority to prescribe controlled substances in schedules III through V in this setting. Authority to prescribe dangerous drugs, nonprescription drugs and devices may be delegated in any setting.
“Yes. Nothing changed for delegation of prescriptive authority for controlled substances in schedules III through V. ”
Can APRNs and PAs in hospital-based clinics continue to prescribe drugs in schedules III through V?
Yes. Nothing changed for delegation of prescriptive authority for controlled substances in schedules III through V.
“... oard Medical Exam, please call the Pre-Licensure, Registration and Consumer Services at (512) 305-7030 to confirm the location of your scores.There is no fee for this verification. ”
How do I get a copy of my examination scores sent to another state?
For physicians only:
If another state board requires your examination grades, please be advised that most physicians will have to contact the Federation of State Medical Boards to obtain examination scores.
Federation of State Medical Boards
400 Fuller Wiser Rd.
Suite 300
Euless, TX 76039-3855
Tel. (817) 868-4000
A small percentage of physicians can obtain verification of examination scores from TMB.
please call the Pre-Licensure, Registration and Consumer Services at (512) 305-7030 to confirm the location of your scores.
There is no fee for this verification.
“... licant for or holder of a license, certificate of registration, or other legal authorization issued by a licensing agency to practice in a specific occupation or profession that is provided to the licensing agency is confidential and is not subject to disclosure under the open records law."The law w ... ”
Is my social security number subject to open records through TMB?
The 76th Legislature passed HB 692, which states in part: "The social security number of an applicant for or holder of a license, certificate of registration, or other legal authorization issued by a licensing agency to practice in a specific occupation or profession that is provided to the licensing agency is confidential and is not subject to disclosure under the open records law."
The law was passed in the House on March 18 and in the Senate on May 17 and went into effect after being signed by Governor George W. Bush on May 29, 1999.
“OBA registration does not apply to physicians who practice in the following settings: An outpatient setting in which only local anesthesia, peripheral nerve blocks, or both are used. Any setting physically located outside the State of Texas. A licensed hospital, including an outpatient facility of t ... ”
Who does not need to register for office-based anesthesia?
OBA registration does not apply to physicians who practice in the following settings:
Note: physicians that provide only level I services, must still meet all other requirements under Chapter 192.
“The registration status “Suspended, Active” is a suspended status. A license in this status is not an active license to practice medicine in Texas. However, a licensee with this status has maintained their registration requirements while the license is suspended, and should that suspensi ... ”
This physician’s profile shows “Registration Status: Suspended, Active”. How can a license be suspended and active at the same time?
The registration status “Suspended, Active” is a suspended status. A license in this status is not an active license to practice medicine in Texas. However, a licensee with this status has maintained their registration requirements while the license is suspended, and should that suspension be lifted, the license can return to an active status without additional registration requirements.
“... ian who may be subject to discipline for improper delegation dependent upon the facts and circumstances of each case, and how state statutes and regulations apply in those situations. ”
Is a CRNA under a valid delegation order, subject to discipline by the Texas Medical Board under the Medical Practice Act for a violation of the standard of care in the selection and administration of anesthesia or the care of an anesthetized patient?
No, while the selection and administration of anesthesia is a medical act, if such an act was validly delegated to a CNRA by a physician, the act is considered to be within the practice of nursing and governed by the Nursing Practice Act. Any discipline for a violation of the standard of care by a CRNA would be carried out by the Texas Board of Nursing under the authority of the Nursing Practice Act. Ultimate responsibility and accountability for the medical management of a patient under anesthesia remains with the delegating physician who may be subject to discipline for improper delegation dependent upon the facts and circumstances of each case, and how state statutes and regulations apply in those situations.
“... uired prior to the completion of your initial TMB registration/renewal, per the new statutory requirement set out in Texas Occupations Code, Sec 601.1111. ”
Why do I have to be fingerprinted for my first NCT Registry renewal with the Texas Medical Board?
The fingerprint background check will be required prior to the completion of your initial TMB registration/renewal, per the new statutory requirement set out in Texas Occupations Code, Sec 601.1111.
“Registration/renewal through TMB will be completed on a different schedule than DSHS, with all permits expiring during specific set times of year (as opposed to expiring in the permit holder’s birth month). Moving forward NCTs on the Registry will expire once a year, on June 30th. As part ... ”
Will I continue to renew my NCT registry in my birth month?
Registration/renewal through TMB will be completed on a different schedule than DSHS, with all permits expiring during specific set times of year (as opposed to expiring in the permit holder’s birth month). Moving forward NCTs on the Registry will expire once a year, on June 30th.
As part of the transition from DSHS to TMB, existing NCTs on the registry will have their first registration (renewal) with TMB per the existing permit expiration date. The renewal fee charged at the time of the first renewal with TMB will be pro-rated to bring the permits in line with the new expiration dates.
“You are not eligible to enter the online registration system until 60-90 days prior to your expiration date. If you are within that time period, please contact us at registrations@tmb.state.tx.us as there may be another issue that is holding up your renewal process.Please note that your fingerprint ... ”
I’m trying to log into the online renewal system and I’m getting an error that says I’m trying to register too early. When can I begin the renewal process?
You are not eligible to enter the online registration system until 60-90 days prior to your expiration date. If you are within that time period, please contact us at registrations@tmb.state.tx.us as there may be another issue that is holding up your renewal process.
Please note that your fingerprint criminal history results must be received prior to your initial renewal with the TMB.
“Registration/renewal through TMB is completed on a different schedule than DSHS, with all permits expiring during specific set times of year (as opposed to expiring in the permit holder’s birth month). MRT and LMRT licensees will expire twice a year, February 28th or August 31st. As ... ”
Will I continue to renew my license in my birth month?
Registration/renewal through TMB is completed on a different schedule than DSHS, with all permits expiring during specific set times of year (as opposed to expiring in the permit holder’s birth month). MRT and LMRT licensees will expire twice a year, February 28th or August 31st.
As part of the transition from DSHS to TMB, existing MRT and LMRT licenses will have their first registration with TMB per the existing permit expiration date. The renewal fee charged at the time of the first renewal with TMB will be pro-rated to bring the permits in line with the new expiration dates.