Physician Salary in Texas (2026)
The average Physician in Texas earns around $275,000/year. After taxes, your estimated take-home is $199,514/year ($16,626/month).✓ No state income tax
Take-Home Pay Breakdown
| Category | Amount |
|---|---|
Annual Take-Home Pay | $199,514 |
Monthly Take-Home Pay | $16,626 |
Biweekly Take-Home Pay | $7,674 |
Hourly Take-Home Pay based on 2,080 hrs/year | $96/hr |
Federal Tax | $59,384 |
State Tax | $0 |
FICA Taxes | $16,102 |
Effective Tax Rate total taxes ÷ gross salary | 27.45% |
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Physician Salary Ranges in Texas
Not all Physicians earn the same — not even close
Texas pays physicians competitively and taxes them at the federal rate only. For a physician earning $400,000, that difference versus California is roughly $45,000–$60,000 per year in take-home pay.
Orthopedic Surgeon
$500,000–$720,000
Houston and DFW markets are strong
Neurosurgeon
$570,000–$800,000
Texas Medical Center commands top rates
Cardiologist (Interventional)
$440,000–$610,000
DFW and Houston high-volume centers
Radiologist
$390,000–$520,000
Teleradiology widely available
Anesthesiologist
$360,000–$470,000
Surgical volume among highest in US
Emergency Medicine
$310,000–$410,000
Rural EM pays premium due to shortage
Psychiatrist
$270,000–$360,000
Acute shortage across the state
OB/GYN
$270,000–$360,000
Malpractice environment has improved
Internal Medicine / Hospitalist
$220,000–$295,000
Nocturnist premium common in TX
Family Medicine / Primary Care
$195,000–$265,000
Rural FP earns significantly more
Worth knowing: The Texas Medical Center in Houston is the largest medical complex in the world. DFW is the fastest-growing major metro, which means new hospital systems and positions opening constantly.
Why Texas is a physician growth market
10,000+
projected TX physician shortage by 2030
$0
state income tax — physician keeps full state earnings
$75k
typical signing bonus in competitive TX specialties
Texas adds roughly 500,000–600,000 new residents every year. The state projects a shortage of over 10,000 physicians by 2030.
Sign-on bonuses of $25,000–$75,000 are common in competitive specialties. Rural practices routinely offer $50,000–$100,000 bonuses plus federal loan forgiveness.
Locum tenens demand in Texas is among the highest nationally. EM locums rates run $170–$250/hour.
The no-state-income-tax advantage compounds over a career. A physician who earns $400,000/year for 20 years in Texas versus California keeps an extra $900,000–$1.2M in pre-tax income.
Texas as a place to live — physician edition
Texas offers genuinely affordable housing in proximity to excellent healthcare systems. A physician can buy a 4-bedroom home in The Woodlands for $600,000–$900,000 — a price range that would get you a 2-bedroom condo in Palo Alto.
Texas summers are brutal. July and August in Houston or San Antonio involve heat indices that make outdoor activity genuinely unpleasant for months.
San Antonio offers the best pure cost-of-living value among major Texas metros, and its military-medical ecosystem creates a sophisticated healthcare community.
How Texas taxes (and DOESN'T tax) work for physicians — what you actually keep
Texas's 0% state income tax is the advantage that defines TX physician comp economics. A specialist earning $500,000 keeps roughly $34,000-$45,000 more annually than the equivalent role in California and $50,000-$55,000 more than NYC. For surgical subspecialists clearing $700,000+, the gap exceeds $50,000-$70,000 annually. Compounded over a 25-year career, the difference is genuinely $1.2M-$2M+ in additional take-home — money that funds private school tuition, second homes, faster mortgage payoff, or larger retirement contributions.
Texas property tax is the offset. TX has no state income tax but property tax averages ~1.6%-2.2% effective on home value (vs CA's ~0.75% under Prop 13). A physician owning a $900,000 home in The Woodlands or Southlake pays $14,000-$20,000 annually in property tax — meaningful enough to factor into total tax math. Critically, Texas DOES have a homestead exemption (basic $40,000 + over-65 / disabled additional $10,000) AND an annual cap on assessed-value growth at 10% for primary residences. Property tax appeal (protesting valuation) is genuinely worthwhile in TX — successful protests are common and can save $1,500-$5,000 annually.
Med school debt strategy works differently in TX than coastal markets. is available at all major academic medical centers (UT MD Anderson, UT Southwestern, Baylor College of Medicine, UTHealth Houston, UT Health San Antonio, Texas Tech HSC), Harris Health (Houston safety-net), Parkland (Dallas safety-net), University Health (San Antonio), and most non-profit health systems (Memorial Hermann, Houston Methodist, HCA, Baylor Scott & White). 10 years of qualifying payments → tax-free forgiveness. For a TX physician with $300K-$500K in med school debt, PSLF can be worth $250K-$450K in pre-tax-equivalent value.
TX private practice partnership is more common than coastal markets. The combination of no state income tax, lower cost of practice, and lower regulatory burden makes ownership-track economics favorable. Private-practice partner physicians use solo ($72,000 limit 2025) plus profit-sharing plus defined-benefit / cash-balance pensions to shelter $100K-$300K+ annually pre-tax. The advantage compounds over a 20-year practice career.
Late-career math: TX is one of the most retirement-favorable states for physicians who built wealth in TX. No state income tax on retirement withdrawals, no estate tax, no inheritance tax, robust homestead exemption, and over-65 property tax freeze (in many counties). Physicians who built TX-based practices and accumulated $3M-$10M+ in retirement assets can withdraw freely without state tax — a major advantage that doesn't exist in CA, NY, NJ, MA, or IL.
- →Max ($24,500 in 2026) — pre-tax federal benefit (no state tax savings since TX has none). Still high-leverage at attending federal marginal rates of 32-37%.
- →Property tax protest annually — most TX counties allow informal protest before May 15. Budget $200-$500 for tax consultant if home value > $750K; consultant fee typically saves $1,500-$5,000 in property tax.
- →Homestead exemption + over-65 freeze — file with appraisal district. Primary residence cap on assessed-value growth at 10%/year. Most counties offer additional exemptions to age 65+ and disabled veterans.
- → eligibility at TX non-profit academic + safety-net systems — UT Southwestern, UT MD Anderson, Baylor College of Medicine, Harris Health, Parkland, University Health, Memorial Hermann, Houston Methodist, BSWH, etc. Worth $250K-$450K of tax-free forgiveness for physicians with significant debt.
- →Solo for moonlighting / 1099 income: up to $72,000 total (2025) for self-employed. TX physicians moonlighting at multiple hospital systems often optimize through this structure.
- →Private practice partnership tax structure: or solo + profit-sharing + DB / cash-balance pension. For surgeons clearing $700K+, this stack can shelter $200K-$300K annually pre-tax. Combined with TX's no state income tax, the take-home advantage vs employed coastal physicians is $100K-$200K+ annually.
- →Late-career retirement strategy: TX residency through retirement avoids state income tax on $2M-$5M+ in retirement withdrawals. For physicians who stayed in TX through working years, the savings is ~$300K-$600K over a 25-year retirement vs CA / NY relocation.
Four Texas physician markets — what each one actually looks like
Texas's physician geography is dominated by four major metros with materially different academic systems, comp structures, and lifestyles.
Houston (Texas Medical Center / Memorial Hermann / Houston Methodist / Harris Health)
Attending: Hospitalist $250K-$330K · Specialist $390K-$610K · Surgical subspecialist $570K-$870KTexas Medical Center is the largest medical complex in the world by physical footprint. UT MD Anderson Cancer Center (consistently top-2 cancer hospital nationally), Houston Methodist (large multi-specialty academic), Memorial Hermann-Texas Medical Center (Level 1 trauma + Children's Memorial Hermann), Baylor College of Medicine (academic teaching), UTHealth Houston, Harris Health System (safety-net at Ben Taub General + LBJ General), MD Anderson West Houston, Texas Children's Hospital. Specialty depth in oncology, cardiology (DeBakey heart program), and pediatric subspecialty is genuinely top-tier nationally.
Houston physician housing in The Woodlands, Memorial, Bellaire, West University, Sugar Land, Katy ranges $700K-$1.5M for top-school zoned 4BR homes — dramatically more accessible than coastal markets at peer comp. Hurricane risk and flood-zone considerations are real (Hurricane Harvey 2017, Imelda 2019); home insurance has risen substantially post-2020.
DFW (UT Southwestern / Baylor Scott & White / Methodist Health / Children's Health)
Attending: Hospitalist $245K-$325K · Specialist $385K-$600K · Surgical subspecialist $560K-$850KUT Southwestern Medical Center (academic, particularly strong in cardiology and neurology), Baylor Scott & White (largest non-profit health system in TX), Methodist Health System, Texas Health Resources, Children's Health Dallas, Parkland Memorial Hospital (safety-net + Level 1 trauma). DFW has grown faster than any major US metro in physician demand. The corporate health system structure (BSWH, THR, Methodist) supports thousands of employed physicians with structured comp + benefits.
DFW physician housing in Southlake, Highland Park, Plano, Frisco, Westlake, Colleyville ranges $800K-$1.8M for top-school zoned homes — competitive with Houston. The DFW airport hub makes traveling-physician practices and locum tenens work accessible.
Austin (Dell Medical School / Ascension Seton / St. David's)
Attending: Hospitalist $235K-$315K · Specialist $370K-$580K · Surgical subspecialist $530K-$800KNewest academic medical center in TX (Dell Medical School at UT Austin opened 2014, growing rapidly). Ascension Seton (Catholic non-profit, dominant Austin presence), St. David's HealthCare (HCA-affiliated, large Austin / Round Rock / Georgetown footprint), Texas Children's Austin (opening 2024-2025). Austin's tech-driven population growth has driven physician demand, particularly in concierge / DPC (direct primary care) practices serving tech executive market.
Austin housing has become surprisingly expensive post-2020 (Westlake / Tarrytown / Travis Heights / Barton Hills $1.2M-$2.5M for entry single-family). Suburban Round Rock / Cedar Park / Georgetown more accessible. Austin's tech-physician market (concierge primary care, executive medicine) is distinctive.
San Antonio (UT Health SA / University Health / Methodist / Christus)
Attending: Hospitalist $225K-$300K · Specialist $355K-$550K · Surgical subspecialist $510K-$770KUT Health San Antonio (academic, strong cancer + research), University Health (Bexar County safety-net, Level 1 trauma), Methodist Healthcare San Antonio, Christus Santa Rosa, Brooke Army Medical Center (BAMC, military, Level 1 trauma + burn center), San Antonio Military Medical Center. The military-medical ecosystem (BAMC, Wilford Hall, Lackland AFB medical) creates a sophisticated medical community in TX.
San Antonio housing the most accessible of major TX metros — Alamo Heights, Stone Oak, Boerne, Helotes 3-4BR homes at $450K-$900K. Cost of living is the advantage: physician comp 5-10% below DFW / Houston, but housing and overall expenses 25-35% lower. Quality-of-life math frequently wins.
The Texas physician career arc — residency to retirement
Texas physician careers typically start in residency at $66,000-$92,000 (PGY1-PGY7), with cost-of-living that's manageable in all four major metros. UT Southwestern, Baylor College of Medicine, UTHealth Houston, UT Health San Antonio, UT Health Tyler, and Texas Tech HSC residencies are all -qualifying. Most TX residents prioritize PSLF-qualifying employer choice immediately upon completion — academic, safety-net, or non-profit health system.
Years 1-5 as an attending are the foundation. Hospitalist starting comp $250K-$330K; specialist $370K-$540K; surgical subspecialist $530K-$680K. Most TX new attendings max immediately, complete Backdoor Roth, and continue qualifying payments. The TX-specific decision points: academic (UT Southwestern / Baylor / UTHealth) vs corporate health system (BSWH / Methodist / Houston Methodist / Memorial Hermann) vs private practice partnership track. Private practice in TX is more accessible than in coastal markets — buy-in costs typically $100K-$400K, partnership comp $100K-$300K above associate level.
Years 5-15 are the peak earning band — and where TX's no-state-tax advantage compounds dramatically. Established specialists clear $450K-$650K; surgical subspecialists at major systems clear $650K-$900K+. Private practice partners in established practices (orthopedics, gastroenterology, dermatology, ophthalmology) routinely clear $800K-$1.2M. The compounded TX vs CA / NY take-home gap during this 10-year peak band is genuinely $400K-$700K — money that funds children's college funds, second homes, expanded retirement contributions, and larger DAF charitable giving than coastal peers can manage at peer gross comp.
Late career (years 15+) is where TX physicians have the retirement advantage. By age 55-60, established TX physicians have typically accumulated $2M-$6M+ in pre-tax retirement accounts plus $1M-$5M+ in private-practice equity, real estate, and after-tax brokerage. TX retirement is genuinely tax-friendly: no state income tax on / IRA / pension withdrawals, no state estate tax, no inheritance tax, generous homestead exemption + over-65 property tax freeze in most counties. Many senior TX physicians stay in TX through retirement (vs the relocation tactic CA / NY physicians use). For physicians with $5M+ retirement accounts, TX residency saves ~$300K-$600K in lifetime state tax vs CA / NY peers.
Where physicians live in Texas
Texas physicians overwhelmingly live in the suburbs of the four major metros.
The Woodlands (Houston)
Near Houston Methodist, Memorial Hermann · top schools · master-planned community
Sugar Land / Katy (Houston)
Diverse, affordable, strong schools · west of Texas Medical Center
Southlake / Colleyville (DFW)
Among top-rated suburbs in Texas · near Baylor Scott & White, Harris Methodist
Frisco / McKinney (DFW)
Fast-growing · newer hospital systems opening · family-popular
Westlake / Rollingwood (Austin)
Close to Ascension Seton, St. David's · expensive but convenient
Alamo Heights (San Antonio)
Medical community hub · near UT Health · best schools in SA metro
Texas traffic is underappreciated as a quality-of-life factor. Budget commute time honestly.
Is this the right move?
The Texas physician opportunity — bottom line
Working in your favor
- +No state income tax — $45,000–$60,000/year more than CA at $400k salary
- +Growing population = growing demand for physicians
- +Texas Medical Center is a world-class research and clinical environment
- +Affordable housing relative to salary in most major metros
- +Strong loan forgiveness programs in rural and HPSA areas
- +Locum tenens market with some of the highest rates nationally
Worth knowing before you sign
- −Brutal summer heat (June–September) limits outdoor lifestyle
- −Rural areas have care access gaps that can be professionally isolating
- −Traffic in all four major metros is genuinely bad
- −Medicaid reimbursement rates lower than many states
- −Healthcare politics can be a friction point for some physicians
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