CSHCN 2009 > Provider Enrollment and Responsibilities > Provider Responsibilities

2.3.1 Information Change Requests

Providers must promptly advise TMHP Provider Enrollment of address changes (office or accounting), name changes, and tax identification number changes. Change information may be communicated in writing to TMHP on the "Provider Information Change Form," which is available in Appendix B, "Forms," on page B-136 and on the TMHP website. A W-9 is required if the provider is changing the mailing or accounting address by written communication sent to TMHP.

Refer to: "Instructions for Completing the Provider Information Change Form" on page B-136.