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Texas Department of Insurance Division of Workers Compensation Medical Fee Dispute Resolution, MS48 7551 Metro Center Drive, Suite 100 Austin, Texas 787441645 5128044000 telephone 5128044811 faxes
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Type your full name into the requester name field.
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What is reguestor name?
The requestor name is the name of the person or entity making a request or inquiry.
Who is required to file reguestor name?
Anyone who is making a request or inquiry is required to provide their requestor name.
How to fill out reguestor name?
To fill out the requestor name, simply write down the name of the person or entity making the request.
What is the purpose of reguestor name?
The purpose of the requestor name is to identify who is making the request or inquiry.
What information must be reported on reguestor name?
The requestor name must include the full legal name of the person or entity making the request.
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