Texas med spa marketing for the growing suburbs, with the supervising doctor on every ad

The Texas Medical Board rewrote its delegation and advertising rules effective January 9, 2025, and the item in the current rule that reaches med spas is 22 TAC 164.3(b)(8). It counts as misleading any failure "to disclose medical directorship, supervision of, or delegation to non-physicians at a location that is not the physician's primary practice location and where care is delivered pursuant to standing orders and protocols." The Board's February 2025 Bulletin put it more bluntly for medical spas and IV hydration clinics: "all advertising materials must feature the supervising physician's name."

The Board defines advertising as "any communication designed to attract attention to the practice of a physician" (22 TAC 164.1), so the rule reaches further than paid ads. What changes in practice:

• The name goes in the ad and everywhere it leads. Meta and Google ad copy, the page each ad lands on, the Instagram bio, the Google Business Profile description and the site footer all carry the supervising physician's name. Where a format leaves no room, such as a short search headline, put the name in an ad asset and on the landing page, and ask your medical director and counsel whether that covers it.
• The lobby and the badges match the ads. The same Bulletin says facilities must post "the name and TMB license number of the delegating physician in all public areas and treatment rooms" and that "all staff must wear ID showing their name and credentials." Titles in ads and bios should read exactly as they do on those badges.
• The doctor owns the archive. 22 TAC 164.2 deems every physician to have "reviewed and approved any and all advertisements" and requires a copy of each to be kept for two years from its last run. A dated folder of every ad, boosted post and email means the medical director never has to rebuild one from memory.
• Photo consent comes first. The same rule says patients "must consent prior to any use of photographs or other representations in any advertising". A signed release belongs in the chart before a result goes on Instagram, not after it does well.
• "Board certified" belongs to physicians. 22 TAC 164.4 allows it only for a physician currently certified by an ABMS member board, the AOA's Bureau of Osteopathic Specialists, the American Board of Oral and Maxillofacial Surgery or a board the TMB approved. "Board-certified injector" on a nurse's bio fails that test.

The rule text applies to a location that is not the physician's primary practice; the Bulletin's wording does not draw that line. Ask your medical director and counsel how the disclosure should read at your location.

SB 140, effective September 1, 2025, rewrote the definition of a telephone solicitation to include "a transmission of a text or graphic message or of an image" sent "to induce a person to purchase, rent, claim, or receive an item." It also made violations of Chapters 304 and 305, the Texas no-call list and the state's TCPA-linked rules, deceptive practices under the DTPA.

A seller that texts promotions to Texans needs a registration certificate for each business location it solicits from (Section 302.101), filed with the Secretary of State as public information (Section 302.102), with a $10,000 security posted under Section 302.107 and a quarterly list of everyone who solicited (Section 302.105). The exemption that fits most client lists, Section 302.058, covers soliciting "a former or current customer" by a business that "has operated under the same business name for at least two years." Section 302.059 holds two more. One covers a business that has run a retail location under the same name for two years, with goods "displayed and offered for sale continuously" and most of its business done there; whether a spa's skincare shelf qualifies is a question for counsel, and it would cover leads as well as clients. The other covers a solicitation that only arranges a face-to-face sales presentation later, with no sale closed and no one sent to collect payment, which a consult invitation might fit. Section 302.051 puts the burden of proving an exemption on the business. So we sort a Texas list into three groups before any promotion goes out:

• Clients who have paid for a treatment, under a name used for two years or more. These fit the customer exemption on its face.
• Leads, free-consult no-shows and gift card buyers who never had a treatment. The statute does not say whether they count as customers. Promotions to them wait for counsel to confirm an exemption or a registration.
• Everyone, at a spa that opened or rebranded in the last two years. Both two-year name tests fail, so neither the customer nor the retail exemption is available yet.

The exemption covers Chapter 302 only. Numbers on the Texas no-call list cannot be called for telemarketing more than 60 days after they appear on it (Section 304.052), unless a narrow exception such as an established business relationship applies (Section 304.004), and Section 305.053 lets a person who gets a message violating the federal TCPA sue in a Texas court for $500 per violation, or up to $1,500 if it was knowing. Our reading is that an appointment confirmation is not sent to induce a purchase while "your Botox is due, save on a booking this week" is; we build those as separate workflows in GoHighLevel so a reminder never carries an offer. Which exemption your own list fits is the question for Texas counsel.

Texas splits a med spa menu between two regulators, and the ad has to follow the split. The Texas Department of Licensing and Regulation's medical spa page says an esthetician may work in any facility with a TDLR establishment license without a physician present, but facial work under that license excludes "injectables, fillers and other types of medical-type procedures that require the use of needles." Light peels that do not pierce the dermis are esthetics; "'Medium peels' and 'deep peels'" are medical procedures under the Medical Board. Microdermabrasion stays in scope only while it removes dead skin from the epidermis. TDLR's who regulates what list sends microneedling, Botox, CoolSculpting and IV hydration to the Medical Board.

• Say who performs each treatment. Before a delegated procedure, 22 TAC 169.26 requires the patient to be told "the identity and title of the individual who will perform the delegated act". The menu page, the booking confirmation and the chat agent's answers should name the same person and title.
• Laser services need their own registration. 25 TAC 289.301 bars using a Class 3B or Class 4 laser except under a Department of State Health Services certificate of registration; IPL devices need no registration but still fall under the rule's safety requirements. Our laser clinic page covers TDLR's hair removal certificates.
• Retire copy that cites 193.17. The old nonsurgical cosmetic rule, 193.17, was repealed effective January 9, 2025; a consent form, bio or blog post that still cites it is out of date.

Jenifer's Law (HB 3749), effective September 1, 2025, regulates elective IV therapy and nothing else on the menu. The bill as filed would have created a "Medical Spas" chapter with a "medical spa director" and a posted notice whenever no physician was present; none of that was enacted. A vendor pitch saying Texas now licenses med spas describes a draft. The IV rules are on our IV therapy page, and delegation and facility setup are covered in how to open a med spa. Scope questions go to TDLR or the Medical Board, whichever the treatment belongs to.