Texas PA license: requirements, steps and renewal

The Texas Physician Assistant Board issues a physician assistant license, and it operates within the Texas Medical Board (TMB), which runs the application portal, the jurisprudence exam and registration. The TMB describes PAs as licensed clinicians who practice medicine under the supervision and delegation of Texas licensed doctors. That framing matters: in Texas, the license lets you practice, but your day-to-day authority comes from your supervising physician's delegation.

Texas is not a member of the PA Licensure Compact, so there is no shortcut from another state's license. If you are moving here, you apply like everyone else. See our PA Licensure Compact guide for where that effort stands nationally.

The board's eligibility checklist also covers PANCE attempts, disciplinary history and pending criminal charges. Read it before you pay the fee.

Texas has a two-stage application process: pre-licensure screening, then licensing. Here is the sequence, start to finish.

1. Finish an accredited PA program and pass the PANCE. You need current NCCPA certification at the time of initial licensure.
2. If you have any criminal history, consider a pre-licensure evaluation first. The TMB offers a pre-licensure criminal history evaluation for a $100 fee. It is not a guarantee of eligibility, and you cannot request one once you have already applied.
3. Submit the online application and fee. The $270 fee must be paid in full before your application can be assigned and processed.
4. Stage 1, screening. Within three business days after you apply, the board emails you a list of documents required for your application. Send everything on that list. The board recommends a trackable overnight service for mailed items.
5. Get fingerprinted after you apply, not before. Fingerprinting is done through IdentoGo by IDEMIA for a fee you pay directly to IdentoGo. Do not mail fingerprint cards to the TMB.
6. Submit lawful presence documentation. Applications remain pending and will not be eligible for approval until it is submitted.
7. Pass the jurisprudence exam. It is available only through your My TMB account. A passing score is 75 or better, and there is no limit on the number of attempts and no cost for each attempt.
8. Stage 2, licensing. Once you are screen complete, a licensing analyst is assigned and emails you requests for any additional items.
9. Optional temporary license. If you file the Temporary License Affidavit and pay $107, you can practice between board staff approval and your scheduled permanent licensing date.
10. Receive your license. Permanent licenses are issued once a month, on scheduled licensing dates.
11. Activate it. Pay your first registration fee within 90 days of your license issue date.
12. Register your supervising physician before you see patients, then apply for your DEA registration. The TMB says you must register your supervising physician(s) with the board before applying for your DEA number.

The board states the rule plainly: in addition to a license, physician assistants in Texas must practice under the supervision of one or more supervising physicians, and if prescribing drugs, must have a prescriptive delegation agreement with their supervising physician(s). The TMB also notes that Texas Occupations Code 157.0512 requires a prescriptive authority agreement between the physician and a PA who has been delegated prescriptive authority.

For agreements executed on or after September 1, 2019, the TMB lists minimum contents. The agreement must, among other things:

• Be in writing, and be reviewed, signed and dated by the parties every year.
• State the nature of the practice, practice locations or practice settings.
• Identify the types or categories of drugs or devices that may, or may not, be prescribed.
• Provide a general plan for consultation and referral, and a plan for patient emergencies.
• Designate any alternate supervising physicians.
• Describe a quality assurance and improvement plan, which must require chart reviews and periodic meetings.

Those meetings must happen at least monthly, no matter how long you and the physician have practiced together. They do not have to be face to face for agreements entered into on or after September 1, 2019. The law does not set a chart review number; the number of charts to be reviewed is determined by the parties to the agreement.

Two registration duties fall on you as the PA. You must register your supervising physicians with the board before you begin practicing under the agreement, and you must notify the board within 30 days of any change to the scope of the delegation. When you change jobs, update supervision before your first shift.

After your first registration, you renew your registration biennially. The board assigns your first registration period, which can run from 6 to 24 months, and after that each registration is two years long. You can renew online 60 to 90 days before expiration.

Do not let it lapse. There is no grace period for the expiration date of a physician assistant license. A penalty equal to half the registration fee applies once the date passes, it rises to a full registration fee after 90 days, and a license expired for one year or longer is automatically cancelled.

Continuing education requirements each cycle:

• At least 40 credits of continuing medical education every 24 months, tied to your registration period rather than the calendar year.
• At least 20 of those hours must be formal Category I credit from a sponsor approved by the American Academy of Physician Assistants.
• At least 2 hours of opioid-related CME if you have a prescriptive authority agreement that authorizes opioids or you have access to the Prescription Monitoring Program.
• A human trafficking prevention course approved by Texas HHSC, completed before each renewal.
• If you treat patients in an emergency room setting, two hours of CME relating to forensic evidence collection. The TMB says this will begin for licenses that expire on February 28, 2027, because no approved coursework was available yet.
• At least 1 hour of CME on nutrition and metabolic health, for licenses that expire on or after May 30, 2027.

Mandatory CE tracking for all TMB licensees began September 1, 2026, through CE Broker. If you are meeting NCCPA certification maintenance, the board presumes you have met the formal and informal hours requirement, but that presumption does not cover every topic-specific course, so check the TMB requirement chart.

One more renewal detail that surprises people: NCCPA certification is required for initial licensure in Texas but not for renewal of an active Texas PA license. Most PAs keep it anyway. Hospital credentialing and payer enrollment often ask for it, so ask any employer whether they require it, and remember that it is required to use the PA Compact in member states.

Texas had 10,110 employed PAs, with a mean annual wage of $135,850 and a median of $134,550 (BLS OEWS, May 2025). In the Austin-Round Rock-San Marcos metro area, 680 PAs were employed, with a mean of $141,290 (BLS OEWS, May 2025). For specialty and metro detail, see our Texas PA salary page.

If you are lining up a Texas job while your application is pending, put the licensing timeline into the offer conversation: a start date contingent on licensure, who pays the fees, and who handles supervising physician registration. Our coaching sessions can help you plan that conversation.