Can a Texas NP prescribe medication independently?

A Texas NP cannot prescribe medication independently. In Texas, an APRN may prescribe only under a physician’s prescriptive authority agreement that defines the scope of delegated prescribing and oversight¹. While the agreement can use flexible orders and protocols, prescribing remains delegation from a physician rather than independent NP authority².

Under delegation, physicians may authorize APRNs to prescribe nonprescription and dangerous drugs³, and may allow prescribing of Schedules III–V controlled substances subject to a 90-day limit per prescription (including refills), physician consultation for any refill, and required consultation for patients under age two³. Schedule II prescribing may only be delegated in hospital facility-based practice or as part of a hospice plan of care for a terminally ill patient⁴; the Texas Board of Pharmacy also advises that the APRN must have appropriate DEA registration and a prescriptive authority agreement to issue Schedule II prescriptions⁵. APRNs’ prescriptions must include specific information—such as both the physician’s and APRN’s identifying details—further underscoring the delegated nature of prescribing in Texas⁶.