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Medical office earns a lower cap rate than ordinary office space for one reason: the improvements are expensive and the tenants rarely move. Plumbing, lead shielding, specialised electrical and a surgical suite are not costs a practice walks away from at lease expiry, and lenders price that stickiness.

What the file turns on

Tenant mix and credit, proximity or affiliation to a hospital system, remaining lease terms, and how much of the build-out was tenant-funded.

Where deals fail

A single-practice building with a retiring owner and no succession plan, and space so specialised that a general-office tenant could never backfill it.

Owner-occupied practices

A dentist or physician buying their own building is a different file from an investor buying a multi-tenant one — practice cash flow does the work, and SBA structures are often the better route.

Our minimum loan is $200,000. We are a direct commercial lender working across the 43 states we serve, in business since 1998. We do not publish a rate for this product because the number depends on the file — call and we will quote the deal in front of us.

SBA loans · Commercial lending · Investment property financing · All loan types · All property types

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Service Areas: Houston | Dallas | Austin | San Antonio | Fort Worth | Near Me TX Construction Rates
Common Questions: Credit Score Required | How Long to Close | Hard Money vs DSCR | Bad Credit OK | DSCR Requirements | No Income Verification | Minimum Down Payment | Documents Required
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Healthcare Real Estate

Medical Office & Healthcare Real Estate Loans in Texas:
Why Physicians and Investors Both Win

Medical office is among the most stable commercial real estate categories — healthcare tenants sign longer leases, move less frequently than any other commercial tenant type, and their businesses are largely recession-proof. Texas's physician population, growing healthcare system, and population influx make medical office one of the most attractive CRE plays in the state. Here's how lenders underwrite it and what terms to expect.

3.1%
TX Medical Office Vacancy
8–12 yrs
Avg Healthcare Lease Term
65–75%
LTV Range
10%
Down (SBA 504 Owner-Occ)
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Long Lease Terms

Healthcare tenants average 8–12 year leases — 2–3× longer than general office. Medical buildout is expensive and tenant-specific, making moves costly.

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Recession-Resistant

People don't stop needing healthcare in a downturn. Medical office occupancy barely moved during 2008–2009 or COVID — the strongest track record of any office subcategory.

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TX Population Growth

Texas adds ~500K residents per year. More residents = more patients = more physician demand. Healthcare employment in Texas grew 4.2% in 2025, outpacing every other sector.

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High TI Cost = Low Turnover

Medical buildout runs $80–200/SF for exam rooms, plumbing, medical gas, and ADA compliance. Tenants absorb that cost and rarely move — protecting your occupancy.

Investor-Owned Medical Office (Leased)

Single-Tenant Medical (NNN)
Physician group or health system on NNN lease. Underwritten like any NNN — on tenant credit and lease term. Hospital-affiliated tenants offer near-investment-grade credit.
LTV: 65–72% · Rate: call for today's rate · DSCR min: 1.20×
Multi-Tenant Medical Office Building (MOB)
3–20 physician/ancillary tenants. Diversified income, lower single-tenant risk. Strong demand from urgent care, imaging, physical therapy, dental groups seeking professional environment.
LTV: 65–72% · Rate: call for today's rate · DSCR min: 1.25×
Ambulatory Surgery Center (ASC)
Outpatient surgical facility — specialized buildout, operator-dependent income. Strong growth nationally as procedures shift from hospital to outpatient setting. Requires healthcare operator track record.
LTV: 60–65% · Rate: call for today's rate · Case-by-case
Behavioral Health / Addiction Treatment
Growing sector. Residential treatment facilities and outpatient behavioral health offices. State licensing is the primary risk variable — lender will verify licenses are current and in good standing.
LTV: 60–65% · Rate: call for today's rate · Licensing docs required

Owner-Occupied Medical Office (Physician-Owned)

Solo Physician Practice
Physician buying the building they practice in. Business cash flow + real estate collateral. SBA 504 at 10% down is the most common structure — 25-year term, below-market blended rate.
SBA 504: 10% down · Conventional: 20–25% · Rate: call for today's rate
Multi-Physician Group Practice
Partnership or PC buying their medical office. Multiple physician borrowers strengthens the credit profile. Common for established groups in primary care, orthopedics, OB/GYN, dermatology.
SBA 504: 10% down · Conv: 20–25% · 51% owner-occ required
Dental Practice
One of the most consistently fundable owner-occupied medical transactions. Dental practice revenue is predictable and insurance-backed. SBA 7(a) often covers both real estate and equipment in one loan.
SBA 7(a)/504: 10% down · Strong credit req: 680+ · 10–25 yr term
Veterinary Practice
Vet clinics have seen strong revenue growth since 2020 — pet ownership surged. Many vet practice owners now buying their building after years of leasing. SBA-eligible, treated like any professional office.
SBA 504: 10% down · Conventional: 20–25% down available

Why SBA 504 Is the Physician's Best Tool for Buying Their Office

The SBA 504 program was practically designed for physician practice owners — here's why it dominates owner-occupied medical office financing:

10% Down

Preserve cash in the practice. A $2M medical office at 10% down = $200K in, not the $400–500K a conventional loan demands. Practice cash flow stays in the business.

25-Year Fixed on the SBA Piece

The CDC debenture (40% of the project) is fixed for 25 years — a rate certainty that no floating-rate commercial loan can match. No refinance risk on 40% of your debt.

No Balloon Payment

Unlike conventional commercial loans that balloon at 5–10 years, the SBA 504 piece is fully amortizing — no forced refinance at a bad time in the rate cycle.

Build Equity Instead of Rent

A physician paying $12K/month in rent builds zero equity. The same payment on a $2M building with SBA 504 builds $600K+ in equity over 10 years while the practice benefits from ownership stability.

Tax Advantages

Depreciation on the building structure reduces taxable income. Interest is deductible as a business expense. A physician in the 37% bracket benefits materially from commercial real estate ownership.

Practice Stays Put

Landlord risk is eliminated. No lease renewal negotiations, no rent increases, no risk of being forced to relocate a practice that has built a patient base around a location over 10+ years.

Medical vs. Standard Office: How Lenders View the Difference

FactorStandard OfficeMedical Office
Average lease term3–5 years8–12 years
Tenant improvement cost ($/SF)$30–60$80–200 (supports sticky tenants)
Vacancy riskHigher — general office oversupplied in many TX marketsLower — healthcare demand is population-driven
Remote work exposureHigh — many firms have reduced footprintsZero — medical care cannot be delivered remotely at scale
Re-tenanting difficultyModerate — generic suite can accommodate many usersHigher cost — medical plumbing/gas buildout is specialized
Typical LTV60–65%65–72% (better collateral perception)
Owner-occupied SBA eligibilityYesYes — often easier to qualify (stable revenue)

Physician Buying Your Office? Investor Building a Medical Portfolio? Let's Talk.

We've structured owner-occupied medical office loans for solo practitioners and group practices, and financed investor-owned MOBs with hospital-system tenants across Texas. SBA 504 at 10% down, conventional at today's rates, or investment loans on leased medical buildings — we do all three. Get a term sheet in 24 hours.

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