I have to thank some of the folks online for helping me figure out fairly quickly what was wrong with my truck.

I have a 2005 F150 XLT Subercab 4x4 with 4.6L

I recently had it detailed to prepare it to sell. When I picked it up it was running terrible. Missing, erratic idle, and then finally stalling. I suspected a fuel issue based on the behavior, then put some dry gas in the tank. No improvement.

I plugged in my Code Scanner and pulled the following codes.

P0171 Fuel System Too Lean (Bank 1)
P0174 Fuel System Too Lean (Bank 2)
P0300 Random, Multiple Misfire Detected
P0190 Fuel Rail Pressure Sensor Circuit Malfunction
P2197 O2 Sensor Signal Stuck Lean

The P0190 Code was what lead me to all of the comments about Fuel Pump Driver Module. I also found some good videos on youtube that describe the problem and show how to replace it.

My truck was stranded in a parking garage so I lowered the spare tire and crawled on the pavement on a blanket to remove the module. Although it was not completely rotted through I could hear loose items internally. Off to the dealership and $160 later I had the new part. Back to the parking garage and in goes the new module. Problem fixed.

I sold the 2005 this weekend and still have a 2004 with a 5.4L that I will use as a beater. It's not in nearly as good shape but it does have the longer box and the 5.4L is much stronger. The 4.6L was a bit of a weak suck. I'm going to order a new Module online for the 2004 and hopefully save some money. I will be proactive as I'm sure it will fail too. I'm also going to change the plugs and check my coil packs, I may just replace them too. I also have the infamous ticking sound, mine is on the left side. It is much noisier when first started and was really bad after a recent oil change. I suspected I had spun a rod bearing, but I now think that was being too pessimistic.

Thanks again to the folks who are kind enough to post when they solve a problem. I am trying to pay back.