Medical Director for Registered Nurses in Texas
An RN can perform a wide range of aesthetic treatments in Texas, but only under physician delegation. We match you with the physician who provides it.

What delegation actually requires
A registered nurse in Texas works under either standing delegation orders or patient-specific orders from a physician. The nursing license itself does not authorize aesthetic medical procedures. The delegation does, and it has to exist in writing before treatment begins.
The supervising physician stays responsible for confirming that the RN is properly trained and operating within scope. That responsibility is why the physician you work with should understand the treatments on your menu, not just sign the paperwork.
What an RN can do under delegation
Injectables
Neurotoxins, dermal fillers, and biostimulators, performed under written protocol after a good faith examination.
Lasers and energy devices
Medical-grade lasers and IPL, under a written protocol covering the specific platform, patient selection, and adverse event response, with documented device training.
Medical-grade skin treatments
Deeper chemical peels and microneedling that penetrate past the epidermis, which sit outside an esthetics license entirely.
Where RNs run into trouble
Two patterns come up repeatedly. The first is a protocol that covers a device the practice no longer uses, or does not cover a device it just bought. Delegation is procedure-specific and platform-specific, so adding equipment means revisiting the protocol before the first treatment, not after. The second is prescribing. An RN cannot prescribe or order prescription products independently in Texas. That authority runs through the physician, or through an NP or PA operating under a prescriptive authority agreement.

What has to be in place
- Written standing delegation orders or patient-specific orders
- A good faith examination before treatment
- Documented training on each specific device and procedure
- A physician available for consultation as the protocol requires
Texas requirement
In Texas, only a physician licensed by the Texas Medical Board, an MD or DO, may serve as a medical director. A nurse practitioner or physician assistant cannot hold the role, though either may perform delegated services under physician supervision.
The medical director’s name and Texas Medical Board license number must be posted in all treatment areas.
Questions RNs ask us
Can I open my own med spa as an RN?
Can I operate lasers?
Do I need a new protocol when I add a service?
Can I prescribe the products I inject?
Find your delegating physician
Tell us what you perform and where you practice. We will match you with a Texas-licensed physician whose experience fits your menu.
(210) 939-8373
Mon-Fri, 9am to 5pm
Tell us about your practice
Two minutes, and no obligation.
More from Texas Med Spa Directors
Medical direction for Texas practices · Good faith exams in Texas · Talk to us about your practice · Texas Botox supervision rules
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