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

Every ad your spa runs now has to name the doctor who supervises it. The same goes for your bio, your Google profile and your website, not only paid ads.

The Texas Medical Board rewrote its delegation and advertising rules on January 9, 2025. The part of its rule on misleading ads that reaches med spas counts this as misleading: failing "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 put it more bluntly for medical spas and IV hydration clinics. Its February 2025 Bulletin says "all advertising materials must feature the supervising physician's name."

Under the Board's definition, advertising is "any communication designed to attract attention to the practice of a physician." So the rule reaches well past paid ads. Here is what changes day to day:

• The name goes in the ad and everywhere it leads. Put the supervising physician's name in Meta and Google ad copy and on the page each ad lands on. It also belongs in the Instagram bio, the Google Business Profile description and the site footer. Some formats leave no room, such as a short search headline. There, put the name in an ad asset and on the landing page, then 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." It adds 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. Under the Board's ad records rule, every physician is deemed to have "reviewed and approved any and all advertisements." A copy of each ad has to be kept for two years from its last run. With a dated folder of every ad, boosted post and email, 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 the post does well.
• "Board certified" belongs to physicians. The Board's certification rule allows the phrase only for a physician with a current certificate from an approved board. Those are ABMS member boards, the AOA's Bureau of Osteopathic Specialists, the American Board of Oral and Maxillofacial Surgery and boards the TMB approved. "Board-certified injector" on a nurse's bio fails that test.

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

A sales text from your spa now counts as a telephone solicitation in Texas. Who you can text without registering depends on two things: whether the person ever paid you, and how long the spa has used its name.

SB 140, the Texas texting law, took effect September 1, 2025. It widened telephone solicitation to include "a transmission of a text or graphic message or of an image." The message counts when it is sent "to induce a person to purchase, rent, claim, or receive an item." The law also made breaking the Texas no-call list and the state's TCPA-linked rules a deceptive practice under the DTPA.

Registering is a real filing. A seller that texts promotions to Texans without an exemption needs:

• a registration certificate for each business location it solicits from
• a filing with the Secretary of State, which is public information
• a $10,000 security posted with the state
• a quarterly list of everyone who solicited

An exemption avoids that filing, but the burden of proving one is on the business. Three could fit a spa:

• Past and current clients. The customer exemption covers soliciting "a former or current customer." The business must have "operated under the same business name for at least two years." This is the one that fits most client lists.
• A retail shelf. A second exemption covers a business that has run a retail location under the same name for two years. Goods must be "displayed and offered for sale continuously" there, and most of the business done there. Whether a spa's skincare shelf qualifies is a question for counsel. If it does, it would cover leads as well as clients.
• An invitation to meet in person. The same section covers a message that only sets up a face-to-face sales presentation later. No sale is closed and no one is sent to collect payment. A consult invitation might fit.

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 law 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. Neither the customer nor the retail exemption is available yet.

These exemptions only cover registration. Two other rules apply to every list:

• The no-call list. Numbers on it cannot be called for telemarketing more than 60 days after they appear.
• Its narrow exceptions. An established business relationship is one narrow exception that can lift the no-call ban.
• Federal texting suits in Texas courts. Someone who gets a message that breaks the federal TCPA can take it to a Texas court. The suit is worth $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. So we build the two as separate workflows in GoHighLevel, and a reminder never carries an offer. Which exemption fits your own list? That is the question for Texas counsel.

Two state agencies split a Texas med spa menu, and your ads have to follow that split. An esthetician can advertise some treatments. Others have to be shown as medical procedures done by a licensed provider.

The Texas Department of Licensing and Regulation (TDLR) covers the esthetics side. Its medical spa page says an esthetician may work in any facility with a TDLR establishment license, with no 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, the Board's delegation rule 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. Texas bars a Class 3B or Class 4 laser except under a Department of State Health Services certificate of registration. IPL devices need no registration, but they 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 took effect September 1, 2025. It regulates elective IV therapy and nothing else on the menu.

As first filed, the bill would have created a "Medical Spas" chapter. It had a "medical spa director" and a posted notice whenever no physician was present. None of that was enacted, so a vendor pitch saying Texas now licenses med spas describes a draft.

The IV rules are on our IV therapy page. 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.