Example: barber
Texas Medicaid Provider Enrollment
Found 1 free book(s)F00139 Texas Medicaid PT, OT, ST Prior Authorization Form
www.tmhp.comF00139 Page 2 of 2 Revised Date: 05/10/2017 | Effective Date: 09/01/2017 Texas Medicaid Physical, Occupational, or Speech Therapy (PT, OT, ST) Prior Authorization Form