Physician Mortgage Loans in Texas: Everything Doctors Need to Know in 2026

Texas has become one of the most popular destinations for physicians in the country, and for good reason. No state income tax. Affordable housing compared to the coasts. Some of the largest medical centers in the world. And a cost of living that actually lets you enjoy your attending salary instead of handing it over to landlords and the IRS.

We close more physician mortgages in Texas than almost any other state. Houston alone accounts for about 20% of our Texas volume—that Texas Medical Center is the largest in the world, and it seems like every physician in America rotates through at some point. Dallas-Fort Worth is close behind, followed by Austin (which has gotten expensive but is still affordable compared to California) and San Antonio.

If you're a physician considering Texas—whether you're training here or relocating for an attending position—this guide covers everything you need to know about buying a home with a physician mortgage.

Why Texas Works So Well for Physicians

Let me start with the financial reality that makes Texas so attractive.

A physician earning $350,000 in California pays approximately $35,000 to $40,000 in state income taxes. That same salary in Texas? Zero state income tax. Over a 30-year career, that difference compounds to over $1 million in additional wealth, assuming you invest the savings.

But here's where it gets really interesting for housing. That $350,000 salary in San Francisco might buy you an $800,000 condo with a long commute. That same $350,000 in Houston buys you a $600,000 home—which is a 3,500 square foot new build in a master-planned community with a pool, good schools, and a 15-minute drive to the hospital.

The combination of higher take-home pay and lower housing costs creates a lifestyle gap that's hard to overstate. We regularly work with physicians who move from coastal cities to Texas and feel like they've gotten a massive raise, even if their base salary stayed the same.

Texas Housing Markets: A City-by-City Breakdown

Texas is a big state with very different housing markets. Let me walk through each major metro so you know what to expect.

Houston

Houston is the largest medical market in Texas and one of the largest in the country. The Texas Medical Center alone employs over 100,000 people and sees 10 million patient encounters per year. Baylor, MD Anderson, Methodist, Memorial Hermann, Texas Children's—the list of major systems goes on and on.

The Houston housing market has something for everyone:

The Inner Loop (inside I-610) - This is where you'll find the classic Houston neighborhoods: Montrose, the Heights, River Oaks, West University, Bellaire. Prices range from $400,000 for a small townhouse in Montrose to $5 million+ in River Oaks. Most physicians we work with buy in the $500,000 to $900,000 range in these areas. The advantages: walkable neighborhoods, established trees, shorter commutes. The disadvantages: older housing stock, smaller lots, flooding concerns in some areas.

The Energy Corridor / Memorial - West Houston along I-10 has become extremely popular with physicians at Memorial Hermann and Methodist. Master-planned communities like Cinco Ranch, Katy, and Cypress offer new construction in the $400,000 to $700,000 range. You get more house for your money, but commutes can be 30-45 minutes depending on traffic and hospital location.

The Woodlands - If you're working anywhere on the north side of Houston, The Woodlands is worth considering. It's a massive master-planned community with excellent schools, beautiful landscaping, and prices from $350,000 to $1.5 million+. The commute to the Medical Center is brutal (60-90 minutes), but if you're at CHI St. Luke's The Woodlands or one of the north Houston facilities, it's ideal.

Pearland / Sugar Land - These southern suburbs have become popular with medical residents and younger attendings. You can find new construction 4-bedroom homes for $350,000 to $500,000, which is hard to beat. The tradeoff is suburban sprawl and longer commutes.

Recent Closing Example - Houston: We closed a $485,000 purchase last month for a cardiology fellow at Methodist. He bought a 2,800 sq ft home in Katy—four bedrooms, three baths, built in 2022. His wife is a pediatrics resident at Texas Children's. Combined, they qualified based on their fellowship and residency income, no attending contracts needed. Their monthly payment including taxes and insurance is $3,850. They were paying $2,400/month for a two-bedroom apartment in the Med Center.

Dallas-Fort Worth

The DFW metroplex is the fourth-largest metro area in the United States, and it's been growing faster than almost anywhere else. UT Southwestern, Baylor Scott & White, Parkland, Medical City—the major systems are well-represented.

Dallas proper has gotten expensive. Highland Park and University Park (the "Park Cities") are some of the most expensive zip codes in Texas, with median prices above $1.5 million. But unlike coastal cities, you don't have to go far to find value.

Popular areas for physicians:

Plano - Excellent schools, close to Legacy medical campuses. $400,000-$700,000 for most homes.
Frisco - Newer construction, rapidly growing. $450,000-$800,000.
Southlake / Colleyville - Premium suburbs, popular with established attendings. $600,000-$1.2 million.
Fort Worth - More affordable than Dallas proper, growing medical infrastructure. $350,000-$550,000.
McKinney / Allen - Farther north but excellent value and schools. $350,000-$500,000.

One thing to know about DFW: the traffic has gotten significantly worse over the past decade. What looks like a reasonable commute on a map can take 45-60 minutes during rush hour. Talk to colleagues at your hospital about actual commute times before buying.

Recent Closing Example - Dallas: An orthopedic surgery attending just signed with Texas Orthopedic Associates. He bought in Prosper (north of Frisco) for $725,000—a 4,200 sq ft new build on half an acre. He put 5% down, no PMI, and qualified using his signed employment contract. His commute to the Plano campus is about 25 minutes against traffic.

Austin

Austin is the outlier in Texas. It's gotten expensive—not San Francisco expensive, but definitely the priciest market in the state. The median home price crossed $550,000 in 2025, and anything close to downtown or the medical campuses runs significantly higher.

Why the premium? Austin has become a major tech hub, and tech money has driven prices up across the board. The University of Texas has expanded its medical programs, and Dell Medical School has become a major training site.

What we're seeing in Austin:

Central Austin / Hyde Park / Rosedale - Classic Austin neighborhoods. $700,000-$1.2 million for modest homes on small lots.
East Austin - Historically affordable but rapidly gentrifying. $500,000-$800,000.
Circle C / Shady Hollow - Southwest Austin suburbs, good schools. $500,000-$750,000.
Cedar Park / Leander - Northwest suburbs, significant growth. $400,000-$600,000.
Round Rock - North of Austin, excellent value. $350,000-$500,000.
Buda / Kyle - South of Austin, most affordable but longer commutes. $300,000-$450,000.

The Dell Medical School campus is in central Austin, so residents there face the toughest housing math. Many choose to live in East Austin or South Austin and deal with 20-30 minute commutes.

Recent Closing Example - Austin: A psychiatry resident at Dell Seton just bought a 1,600 sq ft home in Pflugerville for $385,000. She put 0% down, and we used her signed attending contract with a private practice group starting next year to qualify. Her commute is about 25 minutes, which she considers manageable.

San Antonio

San Antonio is the most affordable of the major Texas metros, and it has a robust medical infrastructure. UT Health San Antonio runs one of the largest training programs in the state, and the military medical presence (Brooke Army Medical Center) is substantial.

Most San Antonio neighborhoods are affordable enough that physician mortgages aren't strictly necessary from a qualification standpoint—but the 0% down and no PMI benefits still make them attractive.

Popular areas:

Alamo Heights / Terrell Hills - San Antonio's most prestigious neighborhoods. $600,000-$1.5 million.
Stone Oak / North Central - Popular with medical professionals, close to hospitals. $350,000-$600,000.
Boerne / Fair Oaks Ranch - Hill Country suburbs, scenic but farther from downtown. $400,000-$700,000.
Medical Center area - Close to South Texas Medical Center. $250,000-$450,000.

Recent Closing Example - San Antonio: A family medicine attending starting with University Health bought in Stone Oak for $420,000. Four bedrooms, 2,400 square feet, built in 2020. He put 5% down and his total monthly payment is $3,150. He was previously renting for $2,100, so his housing cost increase was minimal despite owning a much larger home.

Texas Property Taxes: The Trade-Off

Here's the part that surprises some physicians moving to Texas: the property taxes.

Texas has no state income tax, but property taxes are high—typically 2% to 3% of assessed value annually. For a $500,000 home, expect to pay $10,000 to $15,000 per year in property taxes depending on the specific district.

Let me put that in perspective:

Home Value	Annual Property Tax (2.5%)	Monthly Escrow
$400,000	$10,000	$833
$500,000	$12,500	$1,042
$600,000	$15,000	$1,250
$700,000	$17,500	$1,458

That property tax payment is escrowed with your mortgage, so your total monthly payment is higher than it would be for the same loan amount in a lower-tax state.

However—and this is important—Texas property taxes are still usually a better deal than California or New York state income taxes for high earners. A physician earning $400,000 saves roughly $40,000 per year in state income taxes by living in Texas. Even with a $15,000 property tax bill, you're coming out $25,000 ahead annually.

The math works for most physicians. Just don't be surprised when your total monthly payment seems high relative to the loan amount.

The Texas Homestead Exemption

One benefit that partially offsets property taxes: the Texas homestead exemption.

If a property is your primary residence (your "homestead"), you get automatic reductions in your assessed value for tax purposes. The amounts vary by county and taxing district, but a typical homestead exemption reduces your taxable value by $40,000 to $100,000.

On a $500,000 home with a $60,000 homestead exemption, you're only taxed on $440,000 of value. At a 2.5% tax rate, that saves you $1,500 per year.

Make sure to file for the homestead exemption as soon as you close. It's not automatic—you need to apply with your county appraisal district.

Flooding: The Texas Risk You Can't Ignore

If there's one thing I emphasize with every Texas buyer, it's this: check the flood zone before you make an offer.

Texas floods. Houston floods especially—Hurricane Harvey in 2017 dropped over 60 inches of rain on some areas and caused $125 billion in damage. But flooding happens everywhere in Texas, not just during hurricanes. Dallas floods. Austin floods. San Antonio's Olmos Basin has flooded repeatedly.

FEMA flood maps divide areas into zones:

Zone X (Minimal flood risk) - Standard homeowner's insurance covers you
Zone A or AE (100-year flood zone) - Flood insurance required for federally-backed mortgages
Zone V or VE (Coastal high hazard) - Higher flood risk and insurance requirements

For physician mortgages, we don't require flood insurance unless you're in a designated flood zone. But even in Zone X, flooding can occur. We've seen homes outside the official flood zone get water during Harvey and the 2021 winter storm.

My recommendation: check FEMA flood maps, but also ask neighbors about flood history. Real-world experience matters more than lines on a map.

Texas-Specific Loan Considerations

Home Equity Rules

Texas has unusual rules about home equity and cash-out refinances. The Texas Constitution limits home equity debt to 80% of your home's value, and cash-out refinances are subject to waiting periods and other restrictions.

This doesn't affect your initial purchase, but it's worth knowing if you plan to tap equity later. Texas home equity rules are protective of homeowners but less flexible than other states.

New Construction

A huge percentage of Texas home sales are new construction. Master-planned communities are constantly building, and you'll see plenty of inventory from builders like DR Horton, Lennar, Toll Brothers, and Perry Homes.

Physician mortgages work fine for new construction, but there are some nuances:

Construction timelines slip. Budget extra time and have backup housing plans.
Builder lenders will compete for your business. They often offer incentives like closing cost credits to use their preferred lender. Compare these against our physician mortgage rates—sometimes the builder incentive is worth it, sometimes it's not.
Get a foundation inspection. Texas clay soil causes foundation issues. A $500 inspection can save you $50,000 in future repairs.

HOA Rules

Many Texas subdivisions have HOAs, and some are more restrictive than others. Before buying, review the HOA docs for:

Rental restrictions (relevant if you might relocate before selling)
Pet restrictions
Exterior modification rules (some HOAs are extremely picky)
Monthly/annual dues (typically $50-$200/month in Texas)

We've had buyers back out of contracts after reviewing HOA rules that didn't fit their lifestyle. Read the docs before you're committed.

Buying During Residency in Texas

Texas is one of the best states for residents to buy during training. The affordable prices mean your resident salary can actually qualify for a reasonable home, especially with physician mortgage guidelines.

Let's look at the math for a Texas resident:

Dr. Michael - PGY-2, Internal Medicine, Houston

Annual salary: $68,000
Monthly gross: $5,667
Student loans: $240,000 (on REPAYE, $0 current payment)
Target home: $375,000 in Pearland

Conventional Loan Result:

Student loan DTI charge: $2,400/month (1% rule)
Maximum affordable home: ~$150,000
Result: Cannot qualify for target home

Physician Mortgage Result:

Student loan DTI charge: $0 (excluded)
Debt-to-income: 42%
Result: Qualifies with room to spare

Monthly Payment Breakdown:

Principal & Interest (6.75%): $2,433
Property taxes: $780
Insurance: $180
Total: $3,393

That $3,393 is manageable on a $68,000 salary, especially for a couple where both partners work. And Dr. Michael's attending salary in two years will make the payment even more comfortable.

The Attending Upgrade

Here's a pattern we see constantly in Texas: residents buy starter homes during training, then upgrade to larger homes when they become attendings.

This works well in Texas because:

Transaction costs are lower (title insurance, for example, is regulated and cheaper than coastal states)
Home values have appreciated steadily
Physician mortgage programs are available for your second purchase

We recently worked with a pulmonologist who bought a $320,000 townhouse during fellowship in Houston. Three years later, she sold it for $380,000 and bought a $650,000 home in Memorial. Her equity from the first home covered her down payment on the second.

The key is buying something reasonable the first time—don't stretch to your maximum qualification during residency, because you'll want flexibility later.

Common Questions from Texas Physicians

Should I buy in Houston or Dallas if I'm interviewing at both?

Don't buy until you've committed to a position. Both markets have plenty of inventory, and you won't struggle to find something once you know where you're going. Making an offer before matching or signing a contract just creates stress and potential complications.

Is new construction or resale better?

Personal preference, mostly. New construction offers modern floor plans, builder warranties, and no competition from other buyers (you're buying from the builder). Resale offers established neighborhoods, mature landscaping, and sometimes better value per square foot. We finance both equally.

How do I handle a corporate relocation?

Many hospital systems offer relocation packages that include temporary housing, moving costs, and sometimes even home-buying assistance. Check what your employer offers before making housing decisions. Some relocation packages include lender referrals, but you're not obligated to use them—compare against our physician mortgage terms.

What if I'm military (active duty or veteran)?

If you're eligible for a VA loan, compare VA and physician mortgage options. VA loans offer 0% down with no PMI—similar to physician mortgages—but have different rate structures and funding fees. For some borrowers, VA is better; for others, physician mortgage wins. We can run both scenarios for you.

Getting Started

Texas moves fast in the spring and summer (the hot selling season), but inventory is generally available year-round. Here's how to position yourself for a successful purchase:

Get pre-approved now. Even if you're not buying for six months, knowing your numbers helps you search smarter.
Identify your target areas. Drive the commute during rush hour before committing to a neighborhood.
Connect with a local agent. Texas real estate is local—you want someone who knows the specific neighborhoods and builders in your target area.
Budget for property taxes. Add 25-30% to your principal and interest payment to estimate total monthly costs.
Move quickly when you find the right home. In competitive markets like Austin, homes go pending within days.

We work with Texas physicians every week and understand both the physician loan programs and the local markets. Let's talk through your situation and build a plan that works for your timeline and budget.

Check Your Texas Eligibility →

Tanner Cook | NMLS# 2090424 | Cook Brothers Mortgage Team

Sources:

Texas Comptroller of Public Accounts, Property Tax Information
Houston Association of Realtors, 2025 Market Statistics
North Texas Real Estate Information Systems, DFW Market Report
Austin Board of Realtors, 2025 Housing Report
FEMA Flood Map Service Center
Texas Real Estate Commission, Transaction Cost Data