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By completing this application you are requesting TMHP to deactivate your Texas Medicaid and CSHCN Services Program TPIs. Bear the responsibility for the authenticity of the information being certi ed to. Page 7 Revised 12/01/2016 12/01/16 Effective 01/01/2017 VI. INTERNAL REVIEW REQUIREMENT Provider in accordance with TAC 352. 5 b 1 has conducted an internal review to confirm that neither the applicant Provider or the re-enrolling Provider nor any of its employees or subcontractors as...
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