Texas med spa ownership rules: who can own a med spa in Texas
In Texas, a med spa that offers medical procedures must be owned and controlled by Texas-licensed physicians. Physician assistants and advanced practice registered nurses can hold only a minority stake in an entity they jointly own with physicians, and non-physician founders usually take part by owning a management services organization (MSO) that serves a physician-owned practice. Separate rules then apply to laser hair removal facilities and to elective IV therapy.
- Texas enforces a corporate practice of medicine policy: lay people and lay corporations may not employ physicians to practice medicine or control medical decisions.
- Under Business Organizations Code 301.012, PAs and APRNs may co-own with physicians, but only as a minority, and may not be officers.
- The Texas Medical Board has disciplined physicians who lent their licenses to lay-owned med spas; owners have signed cease-and-desist orders.
- Laser hair removal facilities need a TDLR certificate unless they are owned or operated by a physician for the practice of medicine.
- HB 3749 (in effect since September 1, 2025) limits who may prescribe and administer elective IV therapy outside a physician office or licensed facility.
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Who can own a med spa in Texas
Short answer: physicians, through a properly formed professional entity, with PAs and APRNs allowed a minority share. Everyone else participates through a management company.
Texas reserves the practice of medicine to people licensed by the Texas Medical Board (Occupations Code 155.001). Injections of neurotoxins and fillers, most laser and energy-device treatments, prescription weight-loss programs and IV therapy are medical procedures. The entity that offers them to patients is practicing medicine, so its ownership has to fit Texas law.
The structures that work:
- Physician-owned professional entity. A professional association (PA), professional limited liability company (PLLC) or other entity formed under Title 7 of the Business Organizations Code and owned by Texas-licensed physicians. The American Med Spa Association notes that properly formed Title 7 entities are exempt from the corporate practice concern.
- Joint physician, PA and APRN entity. Business Organizations Code 301.012 lets physicians, physician assistants and advanced practice registered nurses form and own a professional association or PLLC together. The limits matter: PAs and APRNs, alone or combined, may hold only a minority interest; an individual PA's share may not equal or exceed any individual physician owner's; PAs and APRNs may not be officers; and they may not contract with or employ a physician to supervise them.
- MSO plus physician practice. A non-physician, investor group or esthetician-founder owns an MSO that leases the space and equipment and provides non-clinical services to the physician-owned practice for a management fee. The physician practice keeps full control of clinical decisions, clinical staff and patient records.
Texas also exempts some organizations from the corporate practice concern, such as certain hospitals and nonprofit health organizations listed in Texas Medical Board rules. Those rarely apply to a med spa.
How Texas enforces the corporate practice of medicine
Short answer: through physician discipline and actions against lay owners. The physician usually carries the bigger risk.
The American Med Spa Association summarizes the Texas position this way: the policy "generally prohibits non-physicians, lay corporations and other entities from employing a physician to practice medicine." The tools behind it are in the Medical Practice Act: discipline for a physician who aids the unlicensed practice of medicine (Occupations Code 164.052), and penalties for practicing without complying with the Act.
In enforcement actions AmSpa describes, a physician was barred for five years from performing, supervising or delegating med spa procedures for aiding the unlicensed practice of medicine, and the lay owners of the med spas entered agreed cease-and-desist orders with the board. The pattern is the familiar one: a lay-owned spa, a physician paid to be "medical director", and little real physician control.
For independent contractor and management arrangements, the Texas Medical Board looks at the substance, not the label: the flow of funds, who sets fees, ownership, who controls medical decisions, who controls services and employees, and who controls advertising. If the lay company controls those things, the arrangement is at risk whatever the contract says.
Medical director and delegation
Texas physicians may delegate medical acts to qualified staff under Occupations Code Chapter 157, and Texas NPs and PAs prescribe under prescriptive authority agreements with a supervising physician. The details of delegation, supervision and on-site requirements belong in our med spa medical director requirements guide. The ownership point is simpler: the medical director must have real authority inside an entity that Texas law lets practice medicine.
Texas med spa registration checklist
- Pick the structure with a Texas healthcare lawyer. Physician-owned PA or PLLC, joint physician/APRN/PA entity under 301.012, or MSO plus physician practice.
- Form the entities with the Texas Secretary of State. The professional entity for the medical practice and, if used, a regular LLC or corporation for the MSO. Get EINs, a Texas sales tax permit if you sell retail skincare, and any city permits.
- Sign the management services agreement (if using an MSO). Define non-clinical services, a fee your lawyer is comfortable with, and the physician practice's control over clinical staff, protocols, records and supplies.
- Verify every license. TMB licenses for physicians and PAs, Texas Board of Nursing licenses for RNs and APRNs, and TDLR licenses for estheticians. Put prescriptive authority and delegation agreements in writing.
- Laser hair removal: apply for a TDLR laser hair removal facility certificate (16 TAC 118.30) unless the facility is owned or operated by a physician for the practice of medicine. Confirm staff certification requirements with TDLR.
- IV therapy: if you offer elective IV therapy outside a physician office or licensed facility, build HB 3749 into your protocols: physician prescription or delegated prescribing to a PA or APRN, and administration only by a PA, APRN or RN under adequate supervision.
- Drugs and devices: buy prescription products only from authorized distributors, register with the DEA if any controlled substance is involved, and log lot numbers.
- HIPAA and vendor agreements: privacy policies, a security risk assessment, and a Business Associate Agreement with every vendor that touches patient data, including your marketing agency.
What ownership means for your Texas marketing
Short answer: your marketing should name the physician practice that provides care, describe each provider's role accurately, and follow the Texas Medical Board's advertising rules in 22 TAC Chapter 164.
- Who is the provider? If an MSO brand faces the public, make sure the website, Google Business Profile and booking pages identify the physician practice and medical director. Advertising that suggests the spa itself is the licensee is a common source of board attention.
- Who performs what? Do not imply a physician injects when an RN or APRN does. Credentials next to names, plainly.
- Claims and photos. No unsubstantiated superlatives, no stock images presented as results, and signed authorizations for before-and-after photos. Our Texas Medical Board advertising rules guide goes rule by rule, and the before-and-after photo guide covers images.
- Text and email marketing. Promotional texts need prior express written consent; see our med spa TCPA guide.
To see how Texas med spas compare on Google, start with our Texas med spa market report, the national Med Spa Google Presence Report 2026 and our med spa marketing statistics. For hands-on help, see med spa marketing with Ichelon Consulting US.
What we found when we studied 555 US med spas on Google
Patients praise the care almost without exception. The one area where complaints outnumber praise is booking and communication, and that is where most med spas can win.
Full study · 555 US med spas across 20 metros · roughly ±4% nationally · review velocity and themes from a 115-spa subsample · verified against raw data.
Common Texas med spa ownership mistakes
- The rented medical director. A lay-owned LLC pays a physician a monthly fee to sign protocols. This is the fact pattern behind Texas discipline cases.
- Giving an NP or PA majority ownership. Section 301.012 caps PAs and APRNs at a minority, and bars them from officer roles.
- NP-only "independent" spas. Texas APRNs need a prescriptive authority agreement with a physician; Texas is not a full practice state.
- Skipping the laser hair removal certificate because "we have a medical director". The exemption is for facilities owned or operated by a physician, not for lay-owned spas with a physician on contract.
- Mobile or pop-up IV drips with unlicensed staff. HB 3749 ended delegation of elective IV administration to unlicensed personnel.
- An MSO that controls the clinic. If the MSO hires and fires clinical staff, sets protocols or sets fees for medical services, the TMB will look past the paperwork.
Not legal advice: this page summarizes Texas rules as we found them in October 2026 so you can ask better questions. It is not legal advice. Confirm your structure with a Texas healthcare attorney before you sign leases or agreements.
Sources
- Texas Business Organizations Code chapter 301, section 301.012
- Texas Occupations Code chapter 155 (license to practice medicine)
- Texas Occupations Code chapter 157 (delegation and prescriptive authority)
- Texas Occupations Code chapter 164 (physician discipline)
- 16 Texas Administrative Code 118.30: laser hair removal facility certificate
- Texas Legislature: HB 3749 (89th Legislature)
- American Med Spa Association: how the Texas corporate practice of medicine relates to med spa ownership
- American Med Spa Association: Texas IV therapy bill HB 3749 signed into law
Related: ownership rules in all 50 states + DC · all US guides · book a call.
Related pages from the US team
Med spa ownership rules by state
The pillar guide with a 50-state + DC table.
Arizona med spa ownership rules
A neighbor with a very different answer.
California med spa ownership rules
The strictest CPOM regime in the country.
Texas med spa market 2026
Our research on Texas med spas on Google.
Texas Medical Board advertising rules
Rule-by-rule guide to TMB advertising compliance.
Texas healthcare marketing
How our Dallas team works with Texas practices.
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Common questions
Can a non-physician own a med spa in Texas?
Not the medical practice itself. Texas generally prohibits lay people and lay corporations from employing physicians or controlling the practice of medicine. A non-physician can own a management services organization that provides space, equipment, staff administration and marketing to a physician-owned practice, as long as the physician practice keeps control of clinical decisions.
Can a nurse practitioner own a med spa in Texas?
An APRN can co-own a professional association or PLLC with physicians under Business Organizations Code 301.012, but APRNs and PAs together may hold only a minority interest, may not serve as officers, and may not contract with or employ the supervising physician. Texas NPs also need a prescriptive authority agreement with a physician to prescribe, so an NP-only med spa offering medical procedures is not a workable structure in Texas.
Is hiring a medical director enough for a lay-owned Texas med spa?
No. The Texas Medical Board has disciplined physicians for aiding the unlicensed practice of medicine at lay-owned med spas, including barring one physician from performing, supervising or delegating med spa procedures for five years. A medical director needs real authority inside a compliant ownership structure.
Does a Texas med spa need a laser hair removal certificate?
A facility that offers laser hair removal needs a certificate from the Texas Department of Licensing and Regulation under 16 Texas Administrative Code 118.30, unless it is owned or operated by a physician for the practice of medicine, or is a licensed hospital or a clinic owned or operated by one.
What did Texas HB 3749 change for IV therapy?
HB 3749, in effect since September 1, 2025, covers elective IV therapy given outside a physician office or licensed health facility. A physician may delegate prescribing to a PA or APRN, and administration only to a PA, APRN or RN under adequate supervision. Delegation to unlicensed staff is no longer allowed.
What is the Texas medical board advertising rule for med spas?
Texas Medical Board advertising rules sit in 22 Texas Administrative Code Chapter 164. They prohibit false, misleading or deceptive advertising, and the Texas Deceptive Trade Practices Act adds civil exposure. Advertising should name the physician responsible and describe accurately who performs each service.
A note on this guide: it explains marketing practice, not legal advice. Rules on privacy, advertising and insurance change and vary by state, so confirm anything compliance-related with your own counsel.
Running a Texas med spa?
Our US team is based in Dallas. Book a 30-minute call with a member of our Sr. Leadership team and we will review your Google presence, ads and booking flow against Texas advertising rules.