Who can inject
MD, DO, NP, PA, RN under physician delegation
Registered nurses (RNs)
Yes, under physician delegation; supervision requirements vary by board interpretation
Nurse practitioners & physician assistants
NP/PA may inject under physician collaboration; independent practice limited
The exam that makes it legal
Required; in-person exam required before injection A valid order or good-faith exam by an authorized provider is what makes an injection lawful — not simply who holds the syringe.
Training expected
No state-mandated injector training beyond licensure; physician-directed training recommended.
What to verify in Texas
Ensure a qualified Texas-licensed physician serves as medical director and establish written delegation protocols for all RN/NP/PA injectors; document all in-person good-faith exams.
Primary source: Texas Medical Board; Texas Board of Nursing
General business information for Texas medical-spa owners, current as of 2026 — not legal advice. State boards update rules often; confirm specifics with the Texas board (and your own counsel) before you act.