Healthcare Recruiting
Texas PA License 2026: Physician Assistant Requirements, Supervision, and Salary
Texas physician assistants practice under a collaborative practice model with a delegating physician — a written delegation agreement must be filed with the Texas Medical Board (TMB) before the PA may prescribe or practice. Texas is one of the largest PA employer markets in the nation, with major demand across Houston's Texas Medical Center, the Dallas-Fort Worth Metroplex, San Antonio's military-adjacent health systems, and Austin's rapidly expanding care market.
Practice Model: Supervision / Delegation Required
- Written delegation protocol required — filed with and approved by TMB
- Delegating physician must be licensed in Texas
- Prescriptive authority delegated through the protocol (Schedule II–V with DEA registration)
- PAs may have up to 7 delegating physicians on file
- Texas Medical Center (Houston) is the largest medical complex in the world — major PA training and employment hub
Application Requirements
- Active NCCPA certification
- Accredited PA program graduation verification
- Delegation agreement filed and approved
- Background check via TMB
- Application fee ~$206
Processing Timeline
8–10 weeks typical; delegation agreement review may add 2 weeks. Total with DEA approximately 10 weeks.
PA Salary in Texas (2026)
| Setting | Median Base | Typical Sign-On |
|---|---|---|
| Hospital / Inpatient (Houston) | $124,000 | $10,000–$20,000 |
| Hospital / Inpatient (Dallas-Fort Worth) | $122,000 | $8,000–$18,000 |
| Surgical First-Assist | $136,000 | $12,000–$25,000 |
| Primary Care / Outpatient | $110,000 | $5,000–$14,000 |
Top PA Employers in Texas
Houston Methodist (Texas Medical Center flagship), UT Health, Memorial Hermann, and HCA Houston Healthcare dominate Houston. UT Southwestern, Baylor Scott & White, Texas Health Resources, and Methodist Health System anchor Dallas-Fort Worth. University Health / UT Health San Antonio leads the San Antonio market. No state income tax amplifies net compensation across all markets.
What We See at Ava Health
Texas is a top-3 national PA market by volume. No income tax, warm climate, and major system scale create strong attraction. Surgical first-assist in the Texas Medical Center carries some of the highest PA compensation in the country. Austin's tech-adjacent healthcare market is a newer growth corridor with competitive packages.
Related: NP License Texas 2026, PA Salary by State 2026, Healthcare Recruiting in Texas 2026.
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