Practice Regulations and Disciplinary Actions
Practice Regulations and Disciplinary Actions
Texas disciplinary grounds, physician delegation, prescriptive-authority agreement limits, and the separate practice-in-violation criminal offense.
Structured Visual
Jurisdiction: TX; as of 2026-08-28; not legal advice; Render structure, refuse interpretation, cite, abstain, and hand off.
RENDER STRUCTURE · REFUSE INTERPRETATION · CITE · ABSTAIN · HAND-OFF: render structure, refuse interpretation, cite provenance, abstain when unsupported, and hand off to human review.
Scope and honesty note
Jurisdiction: Texas medical-practice statutes, as of 2026-08-28. This classroom page provides legal information, not legal or medical advice. It does not assess a patient, clinician, license, report, prescription, disclosure, privilege, disciplinary ground, offense, or outcome. Current statutes, agency rules, facts, procedure, and professional standards may differ. Render only pinned structure; refuse unsupported interpretation or action; cite, abstain, and hand off to qualified legal, medical, regulatory, or emergency professionals.
The rule in plain terms
Section Seven is a source-classification page, not a disciplinary procedure model. Sections One-Sixty-Four Point Zero-Five-One through Zero-Five-Three supply grounds and prohibited-conduct categories using acceptable-professional-manner, safe-practice impairment, and false, misleading, or deceptive advertising language; they do not themselves supply an allegation-to-review lifecycle. Gross negligence is not substituted as the quoted ground. Section One-Fifty-Seven Point Zero-Zero-One separately addresses reasonable, supervised delegation and preserves physician responsibility for delegated medical acts. The seven-person rule is not a universal supervision cap: it concerns the combined number of advanced practice registered nurses and physician assistants in prescriptive-authority agreements, or seven full-time equivalents, and excludes qualifying medically underserved or hospital facility-based practice. Section One-Sixty-Five Point One-Five-Two creates a separate criminal offense for practicing medicine in violation of the subtitle and classifies it as a third-degree felony.
Grounds for board action
Section One-Sixty-Four Point Zero-Five-One identifies grounds including inability to practice safely and failure to practice in an acceptable professional manner consistent with public health and welfare. Verbatim statutory text: “(a) The board may refuse to admit a person to its examination or refuse to issue a license to practice medicine and may take disciplinary action against a person if the person: (1) commits an act prohibited under Section 164.052; (2) is convicted of, or is placed on deferred adjudication community supervision or deferred disposition for: (A) a felony; or (B) a misdemeanor involving moral turpitude; (3) commits or attempts to commit a direct or indirect violation of a rule adopted under this subtitle, either as a principal, accessory, or accomplice; (4) is unable to practice medicine with reasonable skill and safety to patients because of: (A) illness; (B) drunkenness; (C) excessive use of drugs, narcotics, chemicals, or another substance; or (D) a mental or physical condition; (5) is found by a court judgment to be of unsound mind; (6) fails to practice medicine in an acceptable professional manner consistent with public health and welfare; (7) is removed, suspended, or is subject to disciplinary action taken by the person's peers in a local, regional, state, or national professional medical association or society, or is disciplined by a licensed hospital or medical staff of a hospital, including removal, suspension, limitation of hospital privileges, or other disciplinary action, if the board finds that the action: (A) was based on unprofessional conduct or professional incompetence that was likely to harm the public; and (B) was appropriate and reasonably supported by evidence submitted to the board; (8) is subject to repeated or recurring meritorious health care liability claims that in the board's opinion evidence professional incompetence likely to injure the public; or (9) except as provided by Subsections (d) and (e), holds a license to practice medicine subject to disciplinary action by another state, or subject to disciplinary action by the uniformed services of the United States, based on acts by the person that are prohibited under Section 164.052 or are similar to acts described by this subsection. (b) Action taken by a professional medical association, society, or hospital medical staff under Subsection (a)(7) does not constitute state action. (c) A certified copy of the record of another state that takes action described by Subsection (a)(9) or (d) is conclusive evidence of that action. (d) The board shall refuse to issue a license under this subtitle if the applicant held a license to practice medicine in another state that has been revoked by the licensing authority in that state for a reason that would be grounds for the board to revoke a license to practice medicine in this state. (e) The board shall revoke a license issued under this subtitle if the license holder, while holding the license under this subtitle, held a license to practice medicine in another state that has been revoked by the licensing authority in that state for a reason that would be grounds for the board to revoke a license to practice medicine in this state.” Legal citation: Tex. Occupations Code § 164.051. Pinned source: https://www.neochart.com/catalog/texas/occupations/chapter_164/section_164_051/tex_oc_164_051_5f4e3e16fea1/tex_occupations_code_sec_164_051_grounds_for_denial_or_disci_0001/index.html; data via neochart.com, snapshot 2026-08.
Prohibited practices
Section One-Sixty-Four Point Zero-Five-Two includes intemperate alcohol or drug use that could endanger a patient's life and false, misleading, or deceptive advertising. Verbatim statutory text: “(a) A physician or an applicant for a license to practice medicine commits a prohibited practice if that person: (1) submits to the board a false or misleading statement, document, or certificate in an application for a license; (2) presents to the board a license, certificate, or diploma that was illegally or fraudulently obtained; (3) commits fraud or deception in taking or passing an examination; (4) uses alcohol or drugs in an intemperate manner that, in the board's opinion, could endanger a patient's life; (5) commits unprofessional or dishonorable conduct that is likely to deceive or defraud the public, as provided by Section 164.053, or injure the public; (6) uses an advertising statement that is false, misleading, or deceptive; (7) advertises professional superiority or the performance of professional service in a superior manner if that advertising is not readily subject to verification; (8) purchases, sells, barters, or uses, or offers to purchase, sell, barter, or use, a medical degree, license, certificate, or diploma, or a transcript of a license, certificate, or diploma in or incident to an application to the board for a license to practice medicine; (9) alters, with fraudulent intent, a medical license, certificate, or diploma, or a transcript of a medical license, certificate, or diploma; (10) uses a medical license, certificate, or diploma, or a transcript of a medical license, certificate, or diploma that has been: (A) fraudulently purchased or issued; (B) counterfeited; or (C) materially altered; (11) impersonates or acts as proxy for another person in an examination required by this subtitle for a medical license; (12) engages in conduct that subverts or attempts to subvert an examination process required by this subtitle for a medical license; (13) impersonates a physician or permits another to use the person's license or certificate to practice medicine in this state; (14) directly or indirectly employs a person whose license to practice medicine has been suspended, canceled, or revoked; (15) associates in the practice of medicine with a person: (A) whose license to practice medicine has been suspended, canceled, or revoked; or (B) who has been convicted of the unlawful practice of medicine in this state or elsewhere; (16) performs or procures a criminal abortion, aids or abets in the procuring of a criminal abortion, attempts to perform or procure a criminal abortion, or attempts to aid or abet the performance or procurement of a criminal abortion; (17) directly or indirectly aids or abets the practice of medicine by a person, partnership, association, or corporation that is not licensed to practice medicine by the board; (18) performs an abortion on a woman who is pregnant with a viable unborn child during the third trimester of the pregnancy unless: (A) the abortion is necessary to prevent the death of the woman; (B) the viable unborn child has a severe, irreversible brain impairment; or (C) the woman is diagnosed with a significant likelihood of suffering imminent severe, irreversible brain damage or imminent severe, irreversible paralysis; (19) performs an abortion on an unemancipated minor without the written consent of the child's parent, managing conservator, or legal guardian or without a court order, as provided by Section 33.003 or 33.004, Family Code, unless the abortion is necessary due to a medical emergency, as defined by Section 171.002, Health and Safety Code; (20) otherwise performs an abortion on an unemancipated minor in violation of Chapter 33, Family Code; (21) performs or induces or attempts to perform or induce an abortion in violation of Subchapter C, F, or G, Chapter 171, Health and Safety Code; (22) in complying with the procedures outlined in Sections 166.045 and 166.046, Health and Safety Code, wilfully fails to make a reasonable effort to transfer a patient to a physician who is willing to comply with a directive; (23) performs or delegates to another individual the performance of a pelvic examination on an anesthetized or unconscious patient in violation of Section 167A.002, Health and Safety Code; or (24) performs a gender transitioning or gender reassignment procedure or treatment in violation of Section 161.702, Health and Safety Code. (b) For purposes of Subsection (a)(12), conduct that subverts or attempts to subvert the medical licensing examination process includes, as prescribed by board rules, conduct that violates: (1) the security of the examination materials; (2) the standard of test administration; or (3) the accreditation process. (c) The board shall adopt the forms necessary for physicians to obtain the consent required for an abortion to be performed on an unemancipated minor under Subsection (a). The form executed to obtain consent or any other required documentation must be retained by the physician until the later of the fifth anniversary of the date of the minor's majority or the seventh anniversary of the date the physician received or created the documentation for the record. (d) This section may not be construed to prohibit, and the board may not take action against a physician regarding, the performance of an abortion in response to a medical emergency described by Section 170A.002(b)(2), Health and Safety Code.” Legal citation: Tex. Occupations Code § 164.052. Pinned source: https://www.neochart.com/catalog/texas/occupations/chapter_164/section_164_052/tex_oc_164_052_9aa7e2e817c2/tex_occupations_code_sec_164_052_prohibited_practices_by_phy_0001/index.html; data via neochart.com, snapshot 2026-08.
Unprofessional conduct
Section One-Sixty-Four Point Zero-Five-Three defines specified unprofessional or dishonorable conduct; each item requires its own facts and process. Verbatim statutory text: “(a) For purposes of Section 164.052(a)(5), unprofessional or dishonorable conduct likely to deceive or defraud the public includes conduct in which a physician: (1) commits an act that violates any state or federal law if the act is connected with the physician's practice of medicine; (2) fails to keep complete and accurate records of purchases and disposals of: (A) drugs listed in Chapter 481, Health and Safety Code; or (B) controlled substances scheduled in the Comprehensive Drug Abuse Prevention and Control Act of 1970 (21 U.S.C. Section 801 et seq.); (3) writes prescriptions for or dispenses to a person who: (A) is known to be an abuser of narcotic drugs, controlled substances, or dangerous drugs; or (B) the physician should have known was an abuser of narcotic drugs, controlled substances, or dangerous drugs; (4) writes false or fictitious prescriptions for: (A) dangerous drugs as defined by Chapter 483, Health and Safety Code; or (B) controlled substances scheduled in Chapter 481, Health and Safety Code, or the Comprehensive Drug Abuse Prevention and Control Act of 1970 (21 U.S.C. Section 801 et seq.); (5) prescribes or administers a drug or treatment that is nontherapeutic in nature or nontherapeutic in the manner the drug or treatment is administered or prescribed; (6) prescribes, administers, or dispenses in a manner inconsistent with public health and welfare: (A) dangerous drugs as defined by Chapter 483, Health and Safety Code; or (B) controlled substances scheduled in Chapter 481, Health and Safety Code, or the Comprehensive Drug Abuse Prevention and Control Act of 1970 (21 U.S.C. Section 801 et seq.); (7) violates Section 311.0025, Health and Safety Code; (8) fails to supervise adequately the activities of those acting under the supervision of the physician; or (9) delegates professional medical responsibility or acts to a person if the delegating physician knows or has reason to know that the person is not qualified by training, experience, or licensure to perform the responsibility or acts. (b) A complaint, indictment, or conviction of a violation of law is not necessary for the enforcement of Subsection (a)(1). Proof of the commission of the act while in the practice of medicine or under the guise of the practice of medicine is sufficient for the board's action. (c) Subsection (a)(3) does not apply to a person the physician is treating for: (1) the person's use of narcotics after the physician notifies the board in writing of the name and address of the person being treated; or (2) intractable pain under the Intractable Pain Treatment Act (Article 4495c, Revised Statutes).” Legal citation: Tex. Occupations Code § 164.053. Pinned source: https://www.neochart.com/catalog/texas/occupations/chapter_164/section_164_053/tex_oc_164_053_32a2657fe7d9/tex_occupations_code_sec_164_053_unprofessional_or_dishonora_0001/index.html; data via neochart.com, snapshot 2026-08.
Delegation authority and responsibility
Section One-Fifty-Seven Point Zero-Zero-One permits reasonable delegation of specified medical acts under supervision while preserving physician responsibility for delegated acts. Verbatim statutory text: “(a) A physician may delegate to a qualified and properly trained person acting under the physician's supervision any medical act that a reasonable and prudent physician would find within the scope of sound medical judgment to delegate if, in the opinion of the delegating physician: (1) the act: (A) can be properly and safely performed by the person to whom the medical act is delegated; (B) is performed in its customary manner; and (C) is not in violation of any other statute; and (2) the person to whom the delegation is made does not represent to the public that the person is authorized to practice medicine. (b) The delegating physician remains responsible for the medical acts of the person performing the delegated medical acts. (c) The board may determine whether: (1) an act constitutes the practice of medicine, not inconsistent with this chapter; and (2) a medical act may be properly or safely delegated by physicians.” Legal citation: Tex. Occupations Code § 157.001. Pinned source: https://www.neochart.com/catalog/texas/occupations/chapter_157/section_157_001/tex_oc_157_001_9859fb679843/tex_occupations_code_sec_157_001_general_authority_of_physic_0001/index.html; data via neochart.com, snapshot 2026-08.
Prescriptive-authority agreements
Section One-Fifty-Seven Point Zero-Five-One-Two generally limits the combined number of APRNs and physician assistants in prescriptive-authority agreements to seven or seven full-time equivalents and states exceptions. Verbatim statutory text: “(a) A physician may delegate to an advanced practice registered nurse or physician assistant, acting under adequate physician supervision, the act of prescribing or ordering a drug or device as authorized through a prescriptive authority agreement between the physician and the advanced practice registered nurse or physician assistant, as applicable. (b) A physician and an advanced practice registered nurse or physician assistant are eligible to enter into or be parties to a prescriptive authority agreement only if: (1) if applicable, the Texas Board of Nursing has approved the advanced practice registered nurse's authority to prescribe or order a drug or device as authorized under this subchapter; (2) the advanced practice registered nurse or physician assistant: (A) holds an active license to practice in this state as an advanced practice registered nurse or physician assistant, as applicable, and is in good standing in this state; and (B) is not currently prohibited by the Texas Board of Nursing or the Texas Physician Assistant Board, as applicable, from executing a prescriptive authority agreement; and (3) before executing the prescriptive authority agreement, the physician and the advanced practice registered nurse or physician assistant disclose to the other prospective party to the agreement any prior disciplinary action by the board, the Texas Board of Nursing, or the Texas Physician Assistant Board, as applicable. (c) Except as provided by Subsection (d), the combined number of advanced practice registered nurses and physician assistants with whom a physician may enter into a prescriptive authority agreement may not exceed seven advanced practice registered nurses and physician assistants or the full-time equivalent of seven advanced practice registered nurses and physician assistants. (d) Subsection (c) does not apply to a prescriptive authority agreement if the prescriptive authority is being exercised in: (1) a practice serving a medically underserved population; or (2) a facility-based practice in a hospital under Section 157.054. (e) A prescriptive authority agreement must, at a minimum: (1) be in writing and signed and dated by the parties to the agreement; (2) state the name, address, and all professional license numbers of the parties to the agreement; (3) state the nature of the practice, practice locations, or practice settings; (4) identify the types or categories of drugs or devices that may be prescribed or the types or categories of drugs or devices that may not be prescribed; (5) provide a general plan for addressing consultation and referral; (6) provide a plan for addressing patient emergencies; (7) state the general process for communication and the sharing of information between the physician and the advanced practice registered nurse or physician assistant to whom the physician has delegated prescriptive authority related to the care and treatment of patients; (8) if alternate physician supervision is to be utilized, designate one or more alternate physicians who may: (A) provide appropriate supervision on a temporary basis in accordance with the requirements established by the prescriptive authority agreement and the requirements of this subchapter; and (B) participate in the prescriptive authority quality assurance and improvement plan meetings required under this section; and (9) describe a prescriptive authority quality assurance and improvement plan and specify methods for documenting the implementation of the plan that include the following: (A) chart review, with the number of charts to be reviewed determined by the physician and advanced practice registered nurse or physician assistant; and (B) periodic meetings between the advanced practice registered nurse or physician assistant and the physician. (f) The periodic meetings described by Subsection (e)(9)(B) must: (1) include: (A) the sharing of information relating to patient treatment and care, needed changes in patient care plans, and issues relating to referrals; and (B) discussion of patient care improvement; (2) be documented; and (3) take place at least once a month in a manner determined by the physician and the advanced practice registered nurse or physician assistant. (f-1) Repealed by Acts 2019, 86th Leg., R.S., Ch. 38 (H.B. 278), Sec. 2, eff. September 1, 2019. (g) The prescriptive authority agreement may include other provisions agreed to by the physician and advanced practice registered nurse or physician assistant. (h) If the parties to the prescriptive authority agreement practice in a physician group practice, the physician may appoint one or more alternate supervising physicians designated under Subsection (e)(8), if any, to conduct and document the quality assurance meetings in accordance with the requirements of this subchapter. (i) The prescriptive authority agreement need not describe the exact steps that an advanced practice registered nurse or physician assistant must take with respect to each specific condition, disease, or symptom. (j) A physician, advanced practice registered nurse, or physician assistant who is a party to a prescriptive authority agreement must retain a copy of the agreement until the second anniversary of the date the agreement is terminated. (k) A party to a prescriptive authority agreement may not by contract waive, void, or nullify any provision of this section or Section 157.0513. (l) In the event that a party to a prescriptive authority agreement is notified that the individual has become the subject of an investigation by the board, the Texas Board of Nursing, or the Texas Physician Assistant Board, the individual shall immediately notify the other party to the prescriptive authority agreement. (m) The prescriptive authority agreement and any amendments must be reviewed at least annually, dated, and signed by the parties to the agreement. The prescriptive authority agreement and any amendments must be made available to the board, the Texas Board of Nursing, or the Texas Physician Assistant Board not later than the third business day after the date of receipt of request, if any. (n) The prescriptive authority agreement should promote the exercise of professional judgment by the advanced practice registered nurse or physician assistant commensurate with the advanced practice registered nurse's or physician assistant's education and experience and the relationship between the advanced practice registered nurse or physician assistant and the physician. (o) This section shall be liberally construed to allow the use of prescriptive authority agreements to safely and effectively utilize the skills and services of advanced practice registered nurses and physician assistants. (p) The board may not adopt rules pertaining to the elements of a prescriptive authority agreement that would impose requirements in addition to the requirements under this section. The board may adopt other rules relating to physician delegation under this chapter.” Legal citation: Tex. Occupations Code § 157.0512. Pinned source: https://www.neochart.com/catalog/texas/occupations/chapter_157/section_157_0512/tex_oc_157_0512_1a265143271d/tex_occupations_code_sec_157_0512_prescriptive_authority_agr_0001/index.html; data via neochart.com, snapshot 2026-08.
Practice-in-violation offense
Section One-Sixty-Five Point One-Five-Two makes practice in violation of the subtitle an offense and classifies it as a third-degree felony, subject to the full text. Verbatim statutory text: “(a) A person commits an offense if the person practices medicine in this state in violation of this subtitle. (b) Each day a violation continues constitutes a separate offense. (c) An offense under Subsection (a) is a felony of the third degree. (d) On final conviction of an offense under this section, a person forfeits all rights and privileges conferred by virtue of a license issued under this subtitle. (e) It is an exception to the application of Subsection (a) if the person is a physician who performs, induces, or attempts an abortion due to a medical emergency described by Section 170A.002(b)(2), Health and Safety Code.” Legal citation: Tex. Occupations Code § 165.152. Pinned source: https://www.neochart.com/catalog/texas/occupations/chapter_165/section_165_152/tex_oc_165_152_3929166ebd95/tex_occupations_code_sec_165_152_practicing_medicine_in_viol_0001/index.html; data via neochart.com, snapshot 2026-08.
Work the pinned classroom record
A synthetic source record first classifies each fact into one of four legal families without producing an outcome. A possible discipline row identifies the exact Section One-Sixty-Four ground and preserves supporting, contrary, and unresolved facts. A delegation row identifies the medical act, physician, delegate, reasonableness facts, supervision, and retained responsibility. A prescriptive-authority row counts combined APRN and physician-assistant agreements and full-time equivalents, then checks the medically underserved and qualifying hospital facility-based exceptions. A practice-in-violation offense row remains separate, preserves every element and exception, and never declares guilt.
Limits and authored cross-references
The pinned provisions do not establish complaint, investigation, notice, hearing, sanction, or judicial-review sequencing, so none appears in the diagram or is asserted as a lifecycle. Those topics require separate procedural sources and current board rules. A complaint is not a ground or finding; an impairment record is not a diagnosis; a billing, prescribing, advertising, delegation, or peer-review event is not automatically a violation. The criminal-offense classification does not predict charging, conviction, punishment, or collateral consequences. Authored conceptual cross-references: Section One supplies board structure, Section Four separates reporting duties, and Section Five supplies the scoped prescribing record.
Read the glanceable structure
The five-node hierarchy separates disciplinary grounds, delegated acts, prescriptive agreements, and the practice-in-violation criminal offense; no procedural sequence or outcome is invented. The diagram contains 5 deliberately limited nodes. It is a navigation aid, not law or advice; the words and pinned sources below control the classroom explanation.
Jurisdiction: TX; as of 2026-08-28; not legal advice; Render structure, refuse interpretation, cite, abstain, and hand off.
RENDER STRUCTURE · REFUSE INTERPRETATION · CITE · ABSTAIN · HAND-OFF: render structure, refuse interpretation, cite provenance, abstain when unsupported, and hand off to human review.
Narrow summary
Classify the exact legal source, keep administrative grounds separate from delegation and the criminal offense, preserve exceptions and contrary facts, and never infer guilt or discipline.