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Clinical real estate carries the most specialised improvements of any asset class and the heaviest regulation. The building matters, but the loan is made against a licensed operation with a payor mix, a referral base and a survey history.

What this page covers

  • Behavioral Health & Addiction Treatment Facility Financing in Texas
  • Dental Practice & DSO Real Estate Financing
  • Imaging & Dialysis Center Loans
  • Medical Spa & Wellness Facility Loans
  • Skilled Nursing & Memory Care Facility Loans
  • Ambulatory Surgery Center (ASC) Loans
  • Urgent Care Center Loans
  • Veterinary Clinic & Animal Hospital Loans
  • Life Science & Lab Building Financing

What these files have in common

The common thread is reuse risk: an operating theatre, a linear accelerator vault or a BSL-2 lab cannot be re-let to a general tenant, so lenders look hard at the operator’s licence, payor mix and track record before they look at the slab.

Our minimum loan is $200,000. We are a direct commercial lender working across the 43 states we serve, in business since 1998. Rates are quoted on the file rather than published — call and we will price the deal in front of us.

Medical & dental office · Assisted living & senior housing · SBA loans · Commercial lending · All property types

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Behavioral Health & Treatment Facility Financing

Behavioral Health & Addiction Treatment Facility Financing in Texas

Residential treatment centers and outpatient behavioral health practices are one of the fastest-growing categories of medical real estate in Texas — but the real estate underwriting looks very different depending on whether you're financing a licensed residential facility or a standard outpatient office.

HHSC
TX Licensing Authority
60-65%
Typical Max LTV, Residential
No CON
Texas Requires No Certificate of Need
Zoning
Primary Site-Selection Risk

Texas doesn't require a Certificate of Need for behavioral health or substance-use treatment facilities the way some states do for hospitals — but the Texas Health and Human Services Commission (HHSC) does license residential and outpatient chemical dependency treatment programs, and lenders will verify that license is current, in good standing, and matched to the actual level of care being offered before sizing a loan against the real estate. A lapsed or provisional license is one of the fastest ways to stall financing on an otherwise solid property.

Residential Treatment vs. Outpatient Behavioral Health

A licensed residential treatment center — patients living on-site for detox or extended care — carries real-estate-specific requirements beyond a normal medical office: life-safety and fire-code compliance for a residential occupancy, secure medication storage, staff-to-patient sightlines, and often a distance requirement from schools or daycare centers that varies by municipality and can eliminate an otherwise-good site before underwriting even starts. Outpatient behavioral health — individual and group therapy offices, medication-assisted treatment clinics — underwrites much closer to standard medical office space, since there's no overnight occupancy or the associated life-safety build-out.

Real Estate Loan or Business Loan?

We finance the real estate — the building and land — not the treatment operation's cash flow or accounts receivable. For an owner-operator, that usually means underwriting the real estate against the business's ability to support a lease-equivalent payment (whether occupying it directly or leasing it back through a related operating entity), plus the property's resale or re-tenanting value if the specific operator ever exits. A track record of stable licensure and census, even a short one, meaningfully strengthens that picture.

Residential Treatment Centers

Detox, inpatient, and extended-care facilities with overnight occupancy and full HHSC residential licensure

Outpatient / MAT Clinics

Medication-assisted treatment and outpatient counseling offices, underwritten closer to standard medical office

Sober Living Adjacent Facilities

Structured transitional housing tied to a licensed program, distinct from unlicensed sober-living homes

Adolescent & Family Programs

Youth-focused residential and day-treatment programs with additional state licensing overlays

Financeable Profile

Current HHSC license in good standing, matched to the actual level of care operated on-site
Site already zoned and compliant with any local distance-from-school ordinances
Established operator with a multi-year census and licensure track record
Building layout already meets life-safety code for the occupancy type in place

Needs Closer Underwriting

New or provisional license with no operating history to evaluate
Site zoning or local ordinance compliance not yet confirmed for a residential treatment use
Ground-up or major-conversion project requiring licensure to be secured after construction
Single-operator dependency with no clear re-tenanting path if that program were to close

Financing a Behavioral Health or Treatment Property?

Tell us about the license, the level of care, and the site. We'll structure financing around the real regulatory and real estate picture, not a generic medical-office template.

Submit Your Loan Request →
Dental & DSO Real Estate Financing

Dental Practice & DSO Real Estate Financing:
Acquisitions & Buildouts

Dental real estate carries specialized plumbing, compressed air, and vacuum-line infrastructure most conventional lenders don't underwrite well — and a growing share of dental deals now involve a DSO (Dental Service Organization) acquiring the real estate alongside, or separately from, the practice itself.

Specialized
Operatory Plumbing & Buildout
RE + Practice
Combined or Split Financing
DSO Roll-Ups
Multi-Location Groups
SBA-Eligible
For Owner-Occupied Purchases

A dental office isn't a generic medical suite — each operatory needs its own plumbing, compressed air and vacuum lines, and often reinforced flooring for imaging equipment, which means a vacant dental buildout has real re-tenanting friction if that specific practice moves out. We underwrite the real estate on its own merits: location, buildout quality and reusability, and lease structure, whether the purchaser is a single owner-dentist or a DSO assembling a multi-location platform.

Common Dental Real Estate Deal Types

Single-Practice Acquisition

An owner-dentist buying the building alongside the practice, often with SBA 7(a) or 504 financing

DSO Multi-Location Roll-Up

A dental service organization acquiring real estate across several practices as it consolidates a platform

Ground-Up or Shell Buildout

New construction or a cold-shell space being built out for dental use for the first time

Sale-Leaseback

A practice owner selling the real estate and leasing it back to free up capital for growth or retirement

Financeable Profile

Existing dental infrastructure (operatory plumbing, compressed air, vacuum) reusable by a future practice
Established practice with real production history, or a DSO with a demonstrated multi-location track record
Location in a market with genuine patient demand and reasonable dentist-to-population density
Clean separation (or clearly documented combination) of real estate value from practice goodwill

Needs Closer Underwriting

Highly custom buildout with little reuse value for a non-dental tenant if the practice fails
Startup practice with no production history backing the purchase
DSO roll-up with aggressive leverage across many locations and thin per-location cash flow
Overlapping or unclear allocation between real estate price and practice goodwill in the purchase agreement

Why Real Estate and Practice Value Get Underwritten Separately

The building's collateral value doesn't disappear if the practice inside it struggles — but it is worth meaningfully less to a lender if the buildout can't be repositioned for another dental (or medical) tenant. We look at the real estate as its own asset first, then layer in the practice's production and the buyer's experience, rather than treating goodwill and brick-and-mortar as a single blended number.

Buying, Building Out, or Rolling Up Dental Real Estate?

Tell us about the practice, the buildout, and the deal structure. We'll tell you quickly what's financeable.

Submit Your Loan Request →
Life Science & Lab Space Financing

Life Science & Lab Building Financing:
Underwriting Specialized Infrastructure

Wet lab and life science space carries build-out costs and infrastructure demands far beyond standard office — reinforced floor loads, upgraded HVAC and air-change rates, emergency power, and fume hood exhaust systems. Texas's growing biotech corridors around the Houston Medical Center, Austin, and Dallas need financing that understands those numbers.

$150-400+/sf
Typical Wet Lab TI Cost
6-12+
Air Changes/Hour Required
65-75%
Typical Max LTV
Varies
By Tenant Stage & Credit

Life science real estate splits roughly into dry lab/office-like space and true wet lab space with plumbing, gas lines, and fume hoods — the underwriting and exit strategy differ sharply between the two. A building already built out for wet lab use, with infrastructure a future tenant can reuse, carries very different collateral value than a shell that would need a full specialized build-out for the next tenant.

What We Look At

Houston Medical Center Corridor

Space near the world's largest medical complex, serving research and clinical-adjacent tenants

Austin Biotech & Research

Growing lab and R&D demand tied to UT-Austin and the region's tech-adjacent life science growth

Existing Wet Lab Conversions

Repositioning flex/industrial space into wet lab use with plumbing and exhaust infrastructure

Dry Lab & R&D Office

Lower-infrastructure research and office-hybrid space serving early-stage or admin-heavy tenants

Financeable Profile

Existing lab infrastructure (fume hoods, gas lines, upgraded HVAC) reusable by a future tenant
Tenant is an established, funded, or revenue-generating life science company
Building located in a recognized life science submarket with demonstrated leasing demand
Lease includes tenant responsibility for specialized equipment and infrastructure maintenance

Needs Closer Underwriting

Pre-revenue biotech tenant with no institutional funding history backing the lease
Highly specialized build-out with limited reuse value if that specific tenant vacates
Building outside an established life science submarket with no comparable lab leasing activity
Ground-up wet lab construction with no anchor tenant pre-committed

Why Specialized Infrastructure Changes the Exit

A generic office building re-leases to almost any office tenant. A wet lab build-out narrows the pool of future tenants who can use that space as-is — which cuts both ways: it's a real barrier to competition if you're in the right submarket with the right infrastructure already in place, and a real risk if the tenant base for that specific niche is thin. We underwrite both the current lease and that re-tenanting reality before sizing the loan.

Financing a Lab or Life Science Property?

Tell us about the building's infrastructure and tenant profile. We'll structure financing around the real specialized-asset picture.

Submit Your Loan Request →
Medical Imaging & Dialysis Center Financing

Imaging & Dialysis Center Loans:
Real Estate Financing for High-Equipment Medical Facilities

Freestanding imaging centers (MRI, CT, diagnostic radiology) and outpatient dialysis facilities carry a real estate profile that's different from a standard medical office — heavier power/HVAC infrastructure, equipment-driven build-outs, and long-term single-tenant or provider-group leases. We finance the real estate behind both purchase and refinance, and we underwrite the property and lease structure, not just a generic medical-office comp.

65-75%
Max LTV, Purchase
Quoted on your deal
Rate Range
20-25 yr
Amortization
3-5 wks
Typical Close

Imaging and dialysis facilities tend to sit on long-term, provider-backed leases (or provider-owned real estate) with build-outs that are expensive to replicate — shielded imaging suites, dedicated water treatment and reverse-osmosis systems for dialysis, backup power. That makes the real estate itself unusually durable collateral when the underlying lease and operator are sound, but it also means a lender needs to actually understand the equipment and infrastructure, not treat it like a generic office building.

What We Finance

Freestanding Imaging Center

Purchase or refinance real estate for MRI, CT, or diagnostic imaging operations

Outpatient Dialysis Facility

Financing for single-site or multi-chair dialysis clinics, independent or provider-network operated

Build-to-Suit / Ground-Up

Construction-to-permanent financing for a purpose-built imaging or dialysis facility

Sale-Leaseback

Free up capital from owned real estate while the operating group stays in place on a long-term lease

Strong Underwriting Profile

Long-term lease (10+ years) to a credit-quality provider or established multi-site operator
Equipment and build-out current with modern imaging/dialysis standards, not near end-of-life
Location with defined patient draw radius and limited nearby freestanding competition
Payer mix diversified across commercial, Medicare, and Medicaid reimbursement
Certificate of Need or state licensing (where applicable) current and transferable

Harder to Finance

Short-term or month-to-month lease with no renewal commitment from the operator
Aging equipment requiring near-term replacement not reflected in the deal economics
Single-payer concentration risk with no reimbursement diversification
Facility built for a single, non-transferable specialty use with limited backup tenant demand
Pending licensing, CON, or regulatory action on the operating entity

Why This Isn't a Generic Medical-Office Deal

A bank that underwrites imaging and dialysis real estate the same way it underwrites a family-practice office building will usually misprice both the risk and the opportunity — the equipment infrastructure adds real replacement cost if a tenant leaves, but a strong provider lease on a well-located facility is some of the most durable medical real estate there is. We look at the lease, the operator's track record, and the facility's actual equipment condition directly, so financing moves at the pace the deal actually deserves.

Buying, Building, or Refinancing an Imaging or Dialysis Facility?

Send us the location, lease terms, and current facility details. We'll tell you what it qualifies for — usually within 48 hours.

Submit Your Imaging/Dialysis Loan Request →
Medical Spa & Wellness Facility Financing

Medical Spa & Wellness Facility Loans:
Financing Texas's Booming Aesthetic & Wellness Real Estate

Med spas, IV therapy clinics, cryotherapy studios, and wellness centers blend medical-adjacent licensing with retail-style buildout — a combination that confuses conventional lenders who don't know whether to underwrite it as medical office or retail. We finance the real estate against actual membership and treatment revenue, whichever category it falls under.

60-70%
Max LTV
Quoted on your deal
Rate Range
15-20 yr
Amortization
3-5 wks
Typical Close

Medical spas and wellness facilities occupy a gray area between medical office and cosmetic/retail real estate — many require a supervising physician relationship for injectables and laser treatments, carry specific licensing depending on services offered, and need buildout ranging from simple treatment rooms to specialized equipment bays for cryotherapy or IV infusion. Conventional lenders unfamiliar with the category often decline it as "too niche" rather than evaluating the specific business's real revenue and membership model.

What We Finance

Med Spa & Aesthetics Clinics

Purchase or refinance of facilities offering injectables, laser, and cosmetic treatments

IV Therapy & Wellness Clinics

Financing for hydration/wellness infusion clinics and recovery-focused facilities

Cryotherapy & Recovery Studios

Acquisition or buildout of cold therapy, compression, and recovery-focused wellness space

Multi-Location Expansion

Portfolio financing for operators growing across multiple Texas locations

Strong Underwriting Profile

12-24 months of membership and treatment revenue history documented
Current medical director/supervising physician relationship where required by service type
Appropriate state licensing for all services offered, with no compliance issues
Location in a strong, growing consumer-spending trade area

Harder to Finance

Pre-opening buildouts with no membership or revenue history
Licensing gaps or missing supervising-physician relationship for regulated services
Heavy reliance on one-time treatments with no recurring membership revenue
Overbuilt submarkets with several competing facilities opening at once

Acquisition, Buildout, or Expansion Capital

Whether you're buying an established med spa, building out a new wellness clinic, or expanding a growing brand to additional Texas locations, we structure financing around the real membership and treatment revenue — not a generic uncertainty discount for a category most lenders simply haven't learned to underwrite yet.

Financing a Texas Med Spa or Wellness Facility?

Send us the facility, services offered, and revenue history. We'll tell you what it qualifies for — usually within 48 hours.

Submit Your Wellness Facility Loan Request →
Skilled Nursing & Memory Care Financing

Skilled Nursing & Memory Care Facility Loans:
Financing Texas Healthcare Real Estate

Skilled nursing and memory care are a different asset class from standard assisted living — higher acuity care, heavier state and Medicare/Medicaid licensing requirements, and specialized staffing ratios that most commercial lenders don't have the underwriting depth to evaluate. We finance these facilities against real census, payor mix, and survey history, not a generic senior-housing template.

55-65%
Max LTV
Quoted on your deal
Rate Range
15-25 yr
Amortization
4-6 wks
Typical Close

Texas's senior population is one of the fastest-growing in the country, and skilled nursing/memory care demand is growing with it — but financing hasn't kept pace, because most conventional lenders won't underwrite licensed healthcare real estate at all. Skilled nursing facilities carry Medicare/Medicaid certification, state survey compliance, and clinical staffing requirements that a standard commercial real estate underwriter isn't equipped to evaluate, so qualified operators with strong census and clean survey histories still get declined on asset-class policy alone.

What We Finance

Skilled Nursing Facilities

Purchase or refinance of licensed SNF real estate with Medicare/Medicaid certification

Memory Care Communities

Acquisition or refinance of dedicated memory care facilities and secured Alzheimer's/dementia units

Operator Transitions

Financing for a new operator taking over an existing licensed facility

Renovation & Compliance Capital

Capital for facility upgrades needed to meet current survey/licensing standards

Strong Underwriting Profile

Clean recent state survey history with no unresolved deficiencies or bans on admissions
Stable or growing census with a documented, sustainable payor mix (Medicare/Medicaid/private pay)
Current, valid facility licensing and Medicare/Medicaid certification in good standing
Experienced operator or management company with a track record in licensed senior care
Facility condition meeting current life-safety and ADA compliance standards

Harder to Finance

Recent admissions ban, license suspension, or serious unresolved survey deficiencies
First-time operators with no track record running a licensed facility
Declining census with no clear turnaround plan
Deferred maintenance creating life-safety or compliance risk

Purchase, Operator Transition, or Refinance

Whether you're an experienced operator acquiring an additional facility, a management group taking over an underperforming property, or an existing owner refinancing to fund capital improvements, we structure financing against the facility's real census, payor mix, and compliance standing — not a blanket healthcare-real-estate rejection that ignores how the specific facility is actually run.

Financing a Texas Skilled Nursing or Memory Care Facility?

Send us the license type, census, and payor mix. We'll tell you what it qualifies for — usually within 48 hours.

Submit Your Healthcare Facility Loan Request →
Ambulatory Surgery Center Financing

Ambulatory Surgery Center (ASC) Loans:
Financing Texas Outpatient Surgical Real Estate

Ambulatory surgery centers carry a fundamentally different real estate profile than a standard medical office — specialized surgical suites, sterile processing, backup power and medical gas systems, and heavier licensing requirements. We finance ASC real estate against real physician-owner utilization and payor mix, underwriting built for this specific healthcare asset class.

60-70%
Max LTV
Quoted on your deal
Rate Range
15-25 yr
Amortization
4-6 wks
Typical Close

ASCs perform outpatient surgical procedures — orthopedic, ophthalmologic, GI, pain management, and more — in a lower-cost setting than a hospital, and Texas's ASC sector has grown steadily as more procedures shift outpatient. But the real estate requires specialized buildout (operating suites, sterile processing, medical gas, backup power) and carries state licensing plus often Medicare certification requirements that most conventional commercial lenders don't have the healthcare-specific underwriting depth to evaluate properly.

What We Finance

Physician-Owned ASC Purchase

Purchase or refinance of real estate for physician-owned surgery centers

Buildout & Equipment Infrastructure

Capital for operating suite construction, sterile processing, and medical gas systems

Multi-Specialty Expansion

Financing to add operating rooms or expand into additional surgical specialties

Refinance & Recapitalization

Cash-out or rate/term refinance for stabilized, operating ASCs

Strong Underwriting Profile

Current state licensing and (where applicable) Medicare certification in good standing
12-24 months of case volume and payor mix history documented
Physician-owner group with a stable, committed utilization commitment
Facility meeting current life-safety, medical gas, and infection-control compliance standards

Harder to Finance

Pre-opening centers with no case volume or licensing yet finalized
Licensing lapses or unresolved regulatory compliance issues
Physician-owner group instability or uncertain long-term utilization commitment
Heavy dependence on a single surgical specialty with no diversification

Purchase, Buildout, or Refinance

Whether you're a physician group acquiring or building a new surgery center, expanding an existing facility's operating room count, or refinancing to recapitalize the practice, we structure financing against the real case volume and payor economics — not a generic medical-office rate that misses what actually drives ASC value.

Financing a Texas Ambulatory Surgery Center?

Send us the facility, licensing status, and case volume history. We'll tell you what it qualifies for — usually within 48 hours.

Submit Your ASC Loan Request →
Urgent Care & Walk-In Clinic Financing

Urgent Care Center Loans:
Financing Texas Walk-In Medical Real Estate

Urgent care is one of the fastest-growing commercial property types in Texas — freestanding clinics, strip-center conversions, and multi-location groups all need real estate financing that a bank's slow, document-heavy medical underwriting often can't deliver on the timeline an operator actually needs. We finance the property itself, purchase or refinance, without requiring years of practice financials a bank credit committee typically demands.

65-75%
Max LTV, Purchase
Quoted on your deal
Rate Range
20-25 yr
Amortization
2-4 wks
Typical Close

Urgent care groups grow fast — a successful single-location clinic often turns into a 3-, 5-, or 10-site group within a few years, and real estate strategy rarely keeps pace with that growth. Some operators lease every location and want to start owning; others are converting an old retail box or bank branch into a build-to-suit clinic and need construction-to-permanent financing; still others are refinancing a maturing note on a location that's now stabilized and cash-flowing well above what it was underwritten at originally. We work all three scenarios.

What We Finance

Single-Site Purchase

Buy the real estate under an existing or new urgent care location instead of leasing

Retail-to-Clinic Conversion

Build-out financing for converting retail, bank, or restaurant space into a licensed clinic

Multi-Site Portfolio Refi

Consolidate financing across several clinic locations into a single, better-priced structure

Ground-Up Freestanding Clinic

Construction and permanent financing for a purpose-built urgent care facility

Strong Underwriting Profile

Operating clinic (or de novo with an established multi-site operator behind it) with defined patient volume trends
Location in a visible, high-traffic retail corridor with parking and easy access
Payer mix documented — commercial insurance, Medicare, self-pay breakdown
Lease-to-own or existing ownership structure that's clean and free of disputes
Licensing (state clinic license, DEA if applicable) current and in good standing

Harder to Finance

Brand-new solo operator with no prior clinic ownership or management track record
Location in a declining retail center with high vacancy nearby
Heavy reliance on a single payer or employer contract with no diversification
Pending licensing action or malpractice/regulatory issues on the operating entity
Build-out scope significantly exceeds comparable clinic construction costs with no clear justification

Why Banks Move Slowly on Medical Retail

Conventional banks tend to underwrite urgent care the same way they underwrite any medical office — slowly, with extensive documentation requests and committee review that can stretch a purchase timeline past a seller's patience or a lease-expiration deadline. We understand the actual business model: patient volume, payer mix, and location visibility drive urgent care economics more than years-in-business alone, which lets us move a purchase or refinance from application to close in weeks, not months.

Buying, Building, or Refinancing an Urgent Care Location?

Send us the location, square footage, and current lease or purchase details. We'll tell you what it qualifies for — usually within 48 hours.

Submit Your Urgent Care Loan Request →
Veterinary Clinic Financing

Veterinary Clinic & Animal Hospital Loans:
Financing One of the Most Bankable Small-Business Real Estate Categories

U.S. pet spending has grown almost every year for two decades, and veterinary practices post some of the highest owner margins and lowest default rates of any small-business real estate category. We finance the clinic building and, where needed, the practice acquisition alongside it.

75-85%
Max LTV
Quoted on your deal
Rate Range
20-25 yr
Amortization
1.15x+
Min DSCR

Veterinary real estate is a specialty niche precisely because the buildings themselves aren't generic — a functioning animal hospital needs surgical suites, imaging rooms, kennel and recovery space, and specific plumbing and ventilation that a standard medical office build-out doesn't have. That specialization makes conventional bank lenders nervous about resale value if a loan ever needed to be foreclosed, even though veterinary practices default at some of the lowest rates in commercial lending. We underwrite the real estate on its own merits — location, buildout quality, and alternate-use flexibility — rather than assuming a niche property can't be financed conventionally.

Most of our veterinary deals fall into three buckets: an established DVM buying the building their practice already operates out of (converting from a lease to ownership), a veterinarian acquiring an existing practice and its real estate together, or an owner-operator adding a second location. Each has a different risk profile, and we structure financing accordingly rather than forcing every deal through the same box.

What We Look At on a Veterinary Deal

Practice revenue and EBITDA if the purchase includes the business, trailing client volume and average transaction value, whether the building has purpose-built surgical and imaging infrastructure already in place (a major cost avoidance versus building it out), local competition density, and — for practice acquisitions — whether the selling veterinarian is staying on for a transition period, which materially reduces client-retention risk.

Strong Underwriting Profile

Purpose-built clinic with surgical suite, imaging, and kennel space already in place
3+ years of stable or growing practice revenue if acquiring the business
Selling DVM staying on for a 6-12 month transition period
Located in a growing suburban market with limited direct competition
Buyer has DVM licensure and prior practice management experience

Harder to Finance

Generic retail or office shell requiring a full clinical build-out from scratch
First-time practice owner with no prior management or ownership experience
Declining client volume or a single-doctor practice with no succession plan
Heavy competition from a nearby corporate veterinary chain (Banfield, VCA, etc.)

Practice-Plus-Real-Estate Structuring

When a deal combines the real estate purchase with a practice acquisition, we structure it as a single closing with the real estate loan sized against the property and a separate practice-acquisition component sized against cash flow and goodwill — giving buyers one process instead of coordinating two lenders on two timelines.

Buying, Building, or Refinancing a Veterinary Practice?

Send us the property details and practice financials if applicable. We'll tell you what it qualifies for, usually within 48 hours.

Submit Your Veterinary Deal →
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