How to open a med spa in Texas

1. Can you own a med spa?

Who is allowed to own the business, and in what corporate form?

Texas requires a license to practice medicine and limits interference with physician judgment in the certified organizations described in this section. Chapter 102 separately addresses specified patient-referral remuneration and professional disciplinary consequences, subject to its exceptions and qualifications.

2. The medical oversight you will need

Which physician relationship the state requires, and what they must do.

3. What has to happen before a patient is treated

The exam or provider-patient relationship required before the first injection.

Before a delegated cosmetic act, a physician, or a PA or APRN acting under the physician’s delegation, must establish a practitioner-patient relationship, and an adequate medical record must be maintained. A physician, PA or APRN must be onsite during the procedure or immediately available for emergency consultation, and at least one person trained in basic life support must be present while the patient is onsite.

4. Who may actually inject

Whether an RN, NP, or PA may treat, and under whose supervision.

5. What it costs — the part that is a legal question

We do not publish build-out cost estimates. Fit-out, equipment, lease and staffing are real costs and they are not regulatory monitoring — any figure we gave you would be someone else’s estimate with our name on it. What we can tell you, cited, is which of Texas’s requirements are also spending decisions, because those are the ones that are not optional and the ones with dates attached.

• The physician relationship

  Whatever the state requires here is a recurring cost, not a one-off — a medical director or delegating physician is a paid relationship for as long as you operate.

  A Texas physician may delegate a medical act — including cosmetic injections, dermal fillers, and cosmetic laser use — to a qualified, properly trained person acting under the physician’s supervision, where a reasonable and prudent physician would find it consistent with sound medical judgment. The delegating physician remains responsible for the delegated act.

  Tex. Occ. Code §157.001 · verified Jul 26, 2026

• Registering the facility

  Where a state requires the premises itself to be registered or licensed, that is a filing with a timetable — and a date you can miss.

  A person may not operate a laser hair removal facility without a license issued for that facility, and a separate license is required for each location. The requirement does not apply to a facility owned or operated by a physician for the practice of medicine, to a licensed hospital, or to a clinic owned or operated by a licensed hospital.

  Tex. Health & Safety Code §401.510 · verified Aug 17, 2026

• The corporate structure

  The entity the state permits you to trade through determines what you pay to form and maintain it, and sometimes who has to be on the paperwork.

  Section 102.001(a) makes knowingly offering to pay or agreeing to accept remuneration for securing or soliciting patients or patronage for or from a person licensed, certified or registered by a state health care regulatory agency an offense. Under §102.008, violations of §102.001 or §102.006 are also grounds for disciplinary action by the agency that issued the person’s license, certification or registration. The chapter includes exceptions and qualifications, including §§102.003–102.007; this claim does not establish a blanket rule for owner or management compensation.

  Tex. Occ. Code §§102.001(a), 102.008 · verified Oct 25, 2026

6. What you can put in the syringe

GLP-1 and peptide legality is federal and moves independently of Texaslaw — a compounded product can lose its basis nationwide with no change to your state’s rules. Check current standing before you build a service line around one.

7. What changed in Texas

• TX HB3749: Relating to the regulation of the provision of elective intravenous therapy.

  Jun 20, 2025

Opening a med spa in Texas — FAQ

Can I own a med spa in Texas if I am not a physician?

Texas requires a license to practice medicine and limits interference with physician judgment in the certified organizations described in this section. Chapter 102 separately addresses specified patient-referral remuneration and professional disciplinary consequences, subject to its exceptions and qualifications.(Tex. Occ. Code §§102.001(a), 102.008; verified 2026-10-25) This is regulatory monitoring, not legal advice.

Do I need a medical director to open a med spa in Texas?

A Texas physician may delegate a medical act — including cosmetic injections, dermal fillers, and cosmetic laser use — to a qualified, properly trained person acting under the physician’s supervision, where a reasonable and prudent physician would find it consistent with sound medical judgment. The delegating physician remains responsible for the delegated act.(Tex. Occ. Code §157.001; verified 2026-07-26) This is regulatory monitoring, not legal advice.

Who may operate a cosmetic laser or energy device in Texas?

A Texas physician may delegate a medical act — including cosmetic injections, dermal fillers, and cosmetic laser use — to a qualified, properly trained person acting under the physician’s supervision, where a reasonable and prudent physician would find it consistent with sound medical judgment. The delegating physician remains responsible for the delegated act.(Tex. Occ. Code §157.001; verified 2026-07-26) This is regulatory monitoring, not legal advice.

Does Texas require an exam before a patient can be treated?

Before a delegated cosmetic act, a physician, or a PA or APRN acting under the physician’s delegation, must establish a practitioner-patient relationship, and an adequate medical record must be maintained. A physician, PA or APRN must be onsite during the procedure or immediately available for emergency consultation, and at least one person trained in basic life support must be present while the patient is onsite.(22 TAC §169.26; verified 2026-07-26) This is regulatory monitoring, not legal advice.

Can that exam be done over telehealth in Texas?

For §562.056 prescribing purposes, §111.005(a) recognizes a practitioner-patient relationship when the standard of care is met and the practitioner has a qualifying preexisting relationship, communicates under a qualifying call-coverage agreement, or uses a listed technology pathway. For the technology pathway, the practitioner must access and use the relevant clinical information required by the standard of care. The listed methods are synchronous audiovisual interaction; asynchronous store-and-forward using the specified clinical images or records, including in conjunction with synchronous audio; or another form of audiovisual telecommunication technology that permits compliance with the standard of care. Subsection (b) requires technology-pathway telemedicine practitioners to provide appropriate follow-up guidance and, if the patient consents and has a primary care physician, send that physician the specified treatment and evaluation report within 72 hours. This provision addresses the prescribing relationship; it does not alone establish that a particular cosmetic pre-treatment examination may be remote.(Tex. Occ. Code §111.005(a)–(b); verified 2026-10-25) This is regulatory monitoring, not legal advice.

Can an RN or nurse practitioner inject in Texas?

A registered nurse who is not an APRN (and an LVN) may not perform medical diagnosis or prescribe, but may carry out a delegated medical act — such as administering a cosmetic injection ordered by an appropriately licensed practitioner — when the Board of Nursing’s criteria are met: documented competency/education, written policies and guidelines, an order from an appropriate licensed practitioner, and available medical and nursing support.(Tex. BON Position Statement 15.11; verified 2026-07-26) This is regulatory monitoring, not legal advice.

Does a med spa have to register or hold a license in Texas?

A person may not operate a laser hair removal facility without a license issued for that facility, and a separate license is required for each location. The requirement does not apply to a facility owned or operated by a physician for the practice of medicine, to a licensed hospital, or to a clinic owned or operated by a licensed hospital.(Tex. Health & Safety Code §401.510; verified 2026-08-17) This is regulatory monitoring, not legal advice.

What can a med spa advertise in Texas?

Texas regulates med-spa advertising through the Medical Board’s physician advertising rules, and several bite hardest on a med spa: a TESTIMONIAL is deemed misleading without both a credentials disclaimer and disclosure of compensation; models or actors must be identified as such; an undisclosed MEDICAL DIRECTORSHIP at a non-primary location is deemed misleading; patients must consent before their photographs are used — the before-and-after gallery rule; and a copy of every advertisement must be kept for two years.(22 TAC §164.3(a); verified 2026-08-17) This is regulatory monitoring, not legal advice.

What happens if a med spa in Texas operates without the right license or supervision?

TEXAS KEEPS TWO TRACKS APART, AND A MED SPA CAN BE ON BOTH. Against an unlicensed operator the exposure is criminal and administrative at once: practicing medicine without a license is a third-degree felony with each day a separate offense, holding out as entitled to practice — by advertising, title or stationery — is itself an offense reachable against a business entity, and the Texas Medical Board may issue a cease-and-desist order against an unlicensed person it believes is practicing medicine. Against a licensee the board may refuse a license or take disciplinary action for a prohibited practice, for a felony conviction or a misdemeanor of moral turpitude, or for failing to practice medicine in an acceptable professional manner consistent with public health and welfare. Two enumerated forms of unprofessional or dishonorable conduct are the ones a med spa meets first: failing to supervise adequately the activities of those acting under the physician’s supervision, and delegating medical responsibility to a person the physician knows or has reason to know is not qualified by training, experience, or licensure. A false, misleading or deceptive advertising statement is a prohibited practice in its own right. These claims survey chapters 164 and 165 of the Occupations Code; they do not survey the board’s own rules on sanctions, and no named med-spa enforcement case is cited here.(Tex. Occ. Code §165.152; verified 2026-07-26) This is regulatory monitoring, not legal advice.