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Revised Application for Texas Identification Number Now Available for Pharmacy Enrollment

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The Texas Health and Human Services Commission (HHSC) will stop accepting the Comptroller of Public Accounts version of the Application for Texas Identification Number (Form AP-152) after September 1, 2022. Instead, the Provider Enrollment and Management System (PEMS) will have the new Application for Texas Identification Number (Health and Human Services [HHS] Form 4109).

Pharmacies should begin using the HHS Form 4109 now. PEMS will accept and process any Form AP-152 received before September 1, 2022.

Contact vdp-enrollment@hhsc.state.tx for questions about this change.