Miscellaneous Changes to a Pharmacy License

All changes to a pharmacy license must be submitted in writing and on the appropriate form. If a form does not exist for the change, the pharmacy may submit a written statement that includes, at minimum, the following:

• Pharmacy Name
• Address of the Pharmacy
• Pharmacy License Number
• Detailed Information of request change.
• If changing Number of Hospital Beds or Pharmacy Type for a Class C license – provide a copy of the DSHS Hospital/Ambulatory Surgical Center License.

TSBP may request additional information to verify the information being changed.

These miscellaneous requests may be sent to phcyrenewals@pharmacy.texas.gov.