TMPPM 2009 > Provider Information > Provider Enrollment and Responsibilities > Provider Enrollment

   
 

1.1.4.9 Certificate of Formation or Certificate of Filing/Certificate of Incorporation

All providers that are legal entities must submit the Certificate of Formation or Certificate of Filing form. Obtain the form from the Office of the Secretary of State. The name on this form must match the legal name shown on the W-9 form. Out-of-state providers are exempt from submitting this form.

Texas Corporations formed prior to January 1, 2006, must submit their Certificate of Incorporation.


Texas Medicaid & Healthcare Partnership
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