Form 3047, Office of Primary and Specialty Health Notice of Ineligibility

Texas Health and Human Services

This government document is issued by Texas Health and Human Services for use in Texas

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File Details: PDF (111 KB)
Downloads: 5
Source
https://www.hhs.texas.gov/regulations/forms/3000-3999/form-3047-office-primary-specialty-health-notice-ineligibility

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