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Pain Management Clinics (PMC)

Texas requires pain management clinics (PMC) to be registered with Texas Medical Board.

A “pain management clinic” is a publicly or privately owned facility for which a majority of patients are issued on a monthly basis a prescription for opioids, benzodiazepines, barbiturates, or carisoprodol, but not including suboxone.

Please visit Chapter 195 of the Board rules for the complete regulations.    

Board Rules


  • The physician owner of a pain management clinic must register with the TMB.  Only the primary physician owner is required to register with the board if there is more than one physician owner of the clinic. Each clinic requires a separate certificate.


    When applying for PMC registration the following documentation will be requested:

    • NPDB/HPDB – The clinic’s primary owner, the clinic’s proposed medical director if different, and all physician owners must contact the National Practitioner Data Bank (NPDB)/Healthcare Integrity and Protection Databank (HIPDB) at and perform a self-query. 
    • List of current employees and their license numbers - A complete list of current clinic employees, including contract physicians and other healthcare providers, and their applicable education, qualifications, training, and professional licenses.  Providers at the clinic involved in any part of patient care should have completed at least ten hours of continuing education related to pain management.   Please include current CME certificates for staff as appropriate.
    • Proof of ownership of the clinic – Documents that may demonstrate ownership include:
      • For FEIN (Federal Employer Identification Numbers) tax IDs issued by the IRS used on registration:
        • IRS issued Form SS-4 ;
        • IRS issued form LTR 147c;
        • IRS records for the clinic,
        • certificates of ownership for unincorporated entities issued by a state county. If there are differences in names that can be explained by DBA records with the county, those records should also be submitted. 
      • For State Issued Tax IDs (including State Franchise Tax IDs) tax IDs issued by the SOS used on registration:
        • filings with the Secretary of State,
        • state franchise tax documents,
      • For DBA or Assumed Names the Clinic operates under other than the name listed on the IRS or SOS
        • Certificates of ownership for Assumed names or DBAs issued by a state county.
        • Assumed name certificates filed with the SOS
      • The TMB may require additional documentation if proof of ownership documents submitted are inconclusive for purposes of determining ownership for each owner of the clinic.
    • Clinic protocols and standing delegation orders – A copy of any protocols and standing delegation orders issued by licensed physicians to healthcare providers.
    • Attestation regarding clinic ownership - A separate attestation page is required to be signed by each physician owner (and the medical director, if different).


    Registration is valid for two years and must be renewed.  TMB will send notice of upcoming renewal 60-90 days before actual expiration.  Failure to renew will results in loss of registration and ceasing operation as a PMC.


    There are several types of facilities and clinics that may be exempt from registration.  Those are listed in Chapter 168 of the Texas Occupations Code.  Exemptions must be supported with documentation to prove qualification for the exemption. If you are claiming a clinic location is exempt, please request an exemption worksheet from  



    To ensure compliance with state law and Chapter 195 of the Board rules, TMB utilizes audits, inspections, and investigations.

    The requirements of each of these methods are described fully in Board Rule 195.5.  These methods are used to determine and verify if a clinic needs to be registered, is properly registered, or is exempt.  Also, audits and inspections are both non-disciplinary verification processes.


    You may view the Board Rules on pain management clinic in detail  on our website under Board Rules,Chapter 195.