Medical direction
Medical Director Services in Texas
GuardianMD helps registered nurses, nurse practitioners, and clinic owners find a medical director and put ongoing physician oversight in place. We support physician matching, onboarding, physician-reviewed protocols, chart-review workflows, and records for IV hydration businesses, med spas, and other eligible clinics. Your arrangement is built around your services, your team’s licenses, and the requirements that apply in your state.
Talk to a specialist
Opening, changing physicians, or adding services? Tell us about your plans.
Choosing a physician
How to find a medical director in Texas
GuardianMD provides a Texas-licensed physician to serve as medical director for your clinic. We build the plan around your services, your team, and your locations. Physician fees and the physician’s malpractice coverage are included in your monthly plan.
Running an IV clinic? Texas has a law just for elective IV therapy. It covers IV treatment people seek for wellness or to ease temporary discomfort. It does not cover IV therapy given in a physician’s office or a licensed health facility. Occupations Code 172.001 Talk to a Specialist to see how this law fits your clinic.
Clinical roles
What a medical director does for your clinic
Your medical director is the physician responsible for the clinical oversight duties defined in your arrangement. Those duties may include reviewing protocols, overseeing permitted medical delegation, participating in chart reviews, and setting clear steps for clinical questions and complications. The details depend on your services, your clinical team, and state requirements.
The medical director
Carries out the physician oversight duties for the clinic’s approved services.
The evaluating and ordering clinician
An appropriately authorized clinician evaluates the patient, decides whether treatment is appropriate, and issues the required orders.
The treating registered nurse
Provides nursing care, administers permitted treatments, monitors the patient, and documents and escalates concerns.
RNs practice under their own nursing licenses and remain responsible for their care. If an NP or PA needs a collaborating or supervising physician, that responsibility must also be addressed. The same physician may fill both roles when permitted and appropriate.
Roles vary by state and service. A medical director agreement does not replace patient evaluations, treatment orders, or other applicable requirements.
State requirements
Medical director requirements for clinics in Texas
Texas sets rules for the work behind medical direction. Here are a few to know:
- For elective IV therapy within Chapter 172, a physician may delegate ordering to an APRN or PA and administration to an RN, APRN, or PA under adequate physician supervision. Prescribing delegation also remains subject to Chapter 157. Occupations Code 172.051
- The Texas Medical Board treats nonsurgical cosmetic procedures, like neurotoxin injections, as medical acts. A physician may delegate them to staff with the right training. Texas Medical Board cosmetic procedures guidance
- The Texas Medical Board says elective IV hydration must be given by an RN or a higher-level licensee. Texas Medical Board IV hydration guidance
Decide who evaluates patients, who writes orders, and who gives care. GuardianMD helps you set up these roles with the clinic’s medical director. The clinic’s medical director works with your team on protocols, chart reviews, and clinical questions.
What’s included
What your GuardianMD service includes
GuardianMD helps establish the physician relationship and the systems that support it over time. Your service scope identifies the physician’s responsibilities, the included support, and the fee.
Physician matching and onboarding
We review your services, team credentials, and locations, then coordinate an appropriate physician match and the documents needed to establish the arrangement.
Protocol and chart-review workflows
Keep physician-reviewed protocols, approvals, and the review tasks included in your arrangement organized through the GuardianMD platform.
Physician communication and records
Use DocTalk and centralized records to keep physician discussions, agreements, and review activity connected to the relationship.
Support as your business changes
Review new services, staff changes, and added locations with our team so any changes to the physician arrangement can be addressed.
Patient evaluations and treatment orders are part of planning the clinical workflow. For eligible clinics, GuardianMD Connect offers telehealth clearance exams with a licensed NP or PA working in the same medical practice as the designated physician. Orders are issued when appropriate and permitted. Exams carry a separate per-exam fee, and telehealth suitability depends on the state, service, and patient.
Your business
Medical direction for your Texas business
In IV clinics where nurses give treatments, a physician must order the treatment before the RN gives it. An APRN or PA under physician supervision may also order it. Texas Medical Board IV hydration guidance Have NPs or PAs on your team? See our Texas physician collaboration page.
Chapter 172 defines elective IV therapy by its purpose and setting and excludes administration in a physician’s office and specified licensed or state facilities. That definition does not exempt those settings from other prescribing, nursing, pharmacy, or supervision laws. Occupations Code 172.001 Review each new site, mobile service, or treatment before expanding.
RN limits refer to RN licensure alone, without separate advanced practice prescribing authority. Nursing assessment and nursing diagnosis are different from medical diagnosis. Order requirements concern prescription treatment and other services that legally require an order. A medical director contract does not expand a license. Remote oversight must satisfy any required exams, physician availability, physical presence, and emergency response.
Who we support
Medical director services for different types of healthcare businesses
GuardianMD supports IV hydration businesses, med spas, medical weight loss clinics, functional and longevity medicine practices, primary and urgent care clinics, and mobile healthcare teams. We help arrange physician support around the services offered, the clinicians providing care, and applicable state requirements.
Medical director for IV hydration and infusion clinics
GuardianMD helps IV hydration businesses and eligible infusion clinics establish medical direction around their therapies, nursing team, and care setting. The arrangement addresses physician responsibilities, patient evaluation and ordering workflows, physician-reviewed protocols, and ongoing review for the services involved.
> Explore medical direction for IV hydration and infusion clinics
Medical director for med spas and aesthetic clinics
GuardianMD helps med spas and aesthetic clinics arrange medical direction for the procedures they offer, such as injectables and eligible laser or skin treatments. Physician qualifications, staff training, patient evaluation, and complication-response procedures are considered for the actual treatment menu.
Medical director for medical weight loss clinics
GuardianMD helps medical weight loss clinics, including eligible GLP-1 programs, establish physician oversight around the clinicians who evaluate patients, prescribe, and provide follow-up care. Support can include protocol and chart-review workflows, documented physician communication, and any required NP or PA physician relationship.
> Explore physician oversight for medical weight loss clinics
Medical director for functional and longevity medicine practices
GuardianMD helps functional medicine, longevity, and hormone therapy practices arrange physician support for the services and licensed clinicians involved. The medical direction plan addresses the relevant prescribing, protocol-review, consultation, and documentation workflows as the practice’s services develop.
> Explore medical direction for functional and longevity medicine
Medical director for primary care and urgent care clinics
GuardianMD helps primary care and urgent care clinics identify the physician support appropriate to their services and clinical team. That may involve a clinic medical director, an NP or PA collaborating or supervising physician relationship, or both, depending on state requirements and the practice model.
> Explore physician support for primary care and urgent care
Medical director for mobile healthcare businesses
GuardianMD helps eligible mobile IV, concierge, and mobile wound care businesses arrange physician oversight for care delivered outside a traditional clinic. Planning considers the services, clinicians, treatment locations, patient evaluation process, and communication and escalation procedures for those settings.
The physician relationship your business needs depends on your state, services, clinicians, and practice structure.
Getting started
Getting started with medical direction
Tell us about your plans
Share your services, team licenses, care settings, and opening or transition date.
Define the physician role
Discuss the evaluation and ordering process, physician responsibilities, included support, and fees.
Complete onboarding
Coordinate the physician relationship, documents, and platform setup before beginning the services covered by the arrangement.
Keep the relationship working
Use the agreed communication and review processes, and discuss changes to your services, team, or locations.
Common questions
Medical director services in Texas: FAQs
Can an RN start an IV hydration business or med spa in Texas?
It depends on how the clinic is owned and set up. The Texas Medical Board treats nonsurgical cosmetic procedures as the practice of medicine. A physician may delegate them to trained staff. Texas Medical Board cosmetic procedures guidance Elective IV therapy also runs on physician delegation and supervision. Occupations Code 172.051 So who owns the clinic and who controls medical decisions both matter. Have a qualified attorney review ownership and entity questions. Once the clinic is set up properly, GuardianMD can provide its medical direction. GuardianMD also offers MSO/PC Contractual Support.
Does my Texas clinic need a medical director?
Texas doesn’t use one rule for every clinic. What matters is the work. For elective IV therapy, a physician delegates the ordering and giving of treatment under adequate physician supervision. Occupations Code 172.051 Cosmetic procedures have their own Board supervision standards. Texas Medical Board cosmetic procedures guidance Tell GuardianMD what your clinic offers and who provides it. We’ll help you define the medical director’s role.
Who evaluates patients and orders elective IV therapy before an RN provides it?
For elective IV hydration, the Texas Medical Board says who can order it. It must be a physician, or a PA or APRN under adequate physician supervision. An RN or higher-level licensee then gives the treatment. Texas Medical Board IV hydration guidance Plan each step before your clinic opens, from patient evaluation to monitoring.
Does the medical director need to be on-site in Texas?
Chapter 172 requires adequate physician supervision for delegated elective IV therapy. It does not by itself settle every physical-presence duty. Occupations Code 172.051 For nonsurgical cosmetic procedures, the Medical Board says a physician, PA, or APRN must be on site or immediately available for emergency consultation, and the physician must be able to conduct an emergency appointment if needed. Texas Medical Board cosmetic procedures guidance GuardianMD provides remote oversight through DocTalk, monitored 7 days a week. Routine messaging availability is not a substitute for immediate emergency consultation or an emergency appointment.
Public questions and state resources
Can an RN give elective IV therapy under a physician's delegation in Texas?
Yes. Texas lets a physician delegate the administration of elective IV therapy to an RN under adequate physician supervision. Occupations Code 172.051 The order must still come from a physician, or an APRN or PA under physician supervision. GuardianMD can help your clinic set this up.
What does GuardianMD medical direction cost in Texas?
Pricing depends on your services, clinical team, locations, and the physician responsibilities involved. A GuardianMD specialist can explain the proposed monthly fee and included support. Telehealth clearance exams carry a separate per-exam fee. Tell us about your plans so we can discuss the arrangement that fits your business.
Can my arrangement support mobile visits or additional locations?
Many clinics add locations or mobile visits as they grow. Share each new location, service, and staff plan with GuardianMD before you launch. We’ll review who evaluates patients, how orders reach your nurses, and how emergencies are handled. Then we’ll help you update your clinic’s oversight plan.
State resources
Official Texas resources
State information last reviewed: November 8, 2026
This page offers general information about GuardianMD services and selected state requirements. It is not legal advice or a complete account of the rules for your business. Requirements depend on the services, clinicians, ownership structure, and setting. Consult current official guidance and qualified legal counsel about your circumstances.
Next steps
Find medical direction support for your business
Tell us what you plan to offer, who will provide care, and where you will operate. A GuardianMD specialist can explain the physician relationship, ongoing support, and next steps for your business.
GuardianMD coordinates administrative support and technology for physician relationships. Licensed clinicians carry out clinical care, medical decisions, and any required professional supervision under the laws that apply to them.