If you are interested in Credentialing and
becoming part of the PCHP Provider Network
Please Contact:

Patricia Carney

Provider Relations Manager

Office Phone: 214-266-2121
E-mail: patricia.carney@phhs.org

 

 

 

 

 

 

 

 

 

 

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TEXAS MEDICAID VENDOR DRUG PROGRAM
SYNAGIS® (PALIVIZUMAB) PRIOR AUTHORIZATION REQUEST & PRESCRIPTION FORM .PDF