Texas Medical Board Weighs Doctor Penalties That Fall Below Its Own Minimum

The Texas Medical Board, which licenses and disciplines every physician in the state, meets Oct. 23 to sign off on a stack of disciplinary orders — including cases where the proposed penalty comes in below the board’s own minimum.

It is the first disciplinary item on the list, and it is where the board decides how hard Texas comes down on a doctor. The agenda calls them dispositions below minimum guidelines: proposed outcomes that land under the low end of the sanction range the board’s own disciplinary rules set for a given violation. Those rules do allow the board to go lighter when mitigating factors apply. The notice does not say how many such cases are on the list, what they involve or why a lighter outcome was proposed. No physician is named in it. Nothing on the docket is a finding until the board signs an order, and the board may close the room to discuss investigative material.

Twelve other lines on the agenda are categories of orders rather than named cases — mediated settlements, agreed orders, remedial plans, cease-and-desist orders, consent orders, defaults, modifications and terminations of earlier orders, revised and vacated orders, automatic orders, orders to show cause, and decisions sent over from administrative law judges. The executive director also reports on an internal audit and on a new complaint system. The notice says nothing about what that system is or when it starts.

The board then turns to its own rulebook. It is set to adopt amendments covering four professions it regulates alongside physicians — physician assistants, acupuncturists, medical radiologic technologists and respiratory care practitioners — and to finish a review of every rule the agency has. State law makes an agency re-examine each of its rules within four years and decide whether the reason for writing it still holds. Two further rule lines name no chapter at all. What any of the amendments would do is not in the notice, and the board’s own meeting page still read “Agenda to come” on Oct. 15, so the specifics will not be public before the meeting.

Public comment is set for 8:30 a.m. or later, in the room or over the videoconference. Four board committees — executive, finance, licensure and disciplinary process review — meet Oct. 22, and the full board votes the next morning on what they send up.

Meeting at a glance

Board members

• Sherif Z. Zaafran, M.D. — president; Houston; anesthesiology.
• Kandace B. Farmer, D.O. — vice president; Highland Village; oncology.
• Michael E. Cokinos — secretary-treasurer; Houston; public member.
• Sharon J. Barnes — Rosharon; public member.
• Devinder S. Bhatia, M.D. — Houston; thoracic and cardiovascular surgeon.
• Garry D. Crain — San Marcos; public member.
• George L. De Loach, D.O. — Livingston; orthopedic surgeon.
• James S. Distefano, D.O. — College Station; sports and emergency medicine.
• Mary “Kelly” Green, M.D. — Marble Falls; ophthalmology.
• Tomeka Moses Herod — Allen; public member.
• Zachary S. Jones, M.D. — Frisco; anesthesiology.
• Robert D. Martinez, M.D. — Mission; internal medicine.
• LuAnn Morgan — Midland; public member.
• Jayaram B. Naidu, M.D. — Odessa; primary care and research.
• Manuel M. Quiñones Jr., M.D. — San Antonio; family practice.
• Luisa del Rosal — Dallas; public member.
• Jason K. Tibbels, M.D. — Bridgeport; clinical, hospice and telemedicine.
• Linda Troncoso — El Paso; public member.
• David G. Vanderweide, M.D. — League City; orthopedic surgeon.

Roster from the board’s members page, checked October 15, which lists these 19 members and names Zaafran president, Farmer vice president and Cokinos secretary-treasurer. Cities and specialties are the board’s own wording; the page labels the seven public members only as such and gives no occupation for them. The page carries no last-updated stamp, so the names were cross-checked against the roll call in the board’s minutes of April 13, 2026, which lists the same 19. No appointment release later than April 2026 was searched out, and the board’s August 2026 minutes were not posted where they could be read.