September 22, 2020

Pharmacies should submit re-validation enrollment forms and supporting documents by email or fax:


Fax: 512-206-3948

Pharmacies should submit application fees by US Mail: 

  • Refer to Appendix C in the Pharmacy Enrollment Application (HHS Form 1340) for instructions
  • Payment is allowable as a paper check, money order, or cashier's check
  • Make payment payable to the Texas Health and Human Services Commission (HHSC), and include "ACA Pharmacy Enrollment Fee" and 6-digit vendor ID in the memo line.

Mailing address:

Vendor Drug Program (MC-2250)
Attention: Pharmacy Enrollment
Texas Health and Human Services
4900 North Lamar Blvd.
Austin, TX 78751