Family Medicine & Urgent Care Practice, Houston Texas

$1.2M

Revenue

$594K

SDE

2.0x

Multiple

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Full Editorial Writeup

This is a Houston-based family medicine practice with an integrated urgent care and walk-in component, offering primary care, minor procedures, women's health services, ECGs, nebulizer treatments, and point-of-care testing. The practice runs a CLIA-certified lab, provides on-site phlebotomy, and performs immigration medical examinations, giving it multiple complementary revenue streams beyond straight office visits. It operates from a compact 1,500 square foot leased facility with four exam rooms located near hospitals and major transportation routes.

The financials are the headline. The practice generated roughly $1.2 million in revenue in 2025 with nearly 12% year-over-year growth, and cash flow (SDE) of $594,000 against a $1,198,000 asking price, a 2.02x multiple. Note the tension in the broker's own numbers: they cite net income of approximately $189,000 while also citing SDE of $594,000, which means most of the buyer's return is riding on owner add-backs, primarily physician compensation. A buyer who is a physician can step into the clinical seat and capture that spread; a buyer who is not must hire a physician and the economics shift materially.

The payer mix is the quiet strength here. At roughly 71% commercial insurance with the remainder mostly Medicare and self-pay and minimal Medicaid, this practice collects at healthier reimbursement rates than a Medicaid-heavy clinic. Combined with a multigenerational, loyal patient base and Houston's growing population, this is a durable, essential-service cash flow business rather than a discretionary play.

Why we like it

Earnings quality is anchored by a 71% commercial payer mix with minimal Medicaid exposure, which means higher reimbursement per visit and less collections friction than a safety-net clinic. The multiple ancillary lines (CLIA lab, phlebotomy, immigration exams, in-office procedures) diversify revenue beyond straight office visits. At a stated 2.02x SDE, the entry price is disciplined for a healthcare service business.
Family medicine plus urgent care is about as recession-resistant as small business gets, because people get sick and need care regardless of the economy. The multigenerational, loyal patient base creates recurring demand and switching costs that most SMBs never build. Walk-in and urgent care volume adds a steady, acute-need layer on top of the chronic-care base.
Houston is a large and growing healthcare market, and the location sits near hospitals, complementary providers, and major transport routes. Population growth and inbound demand support the stated near 12% year-over-year revenue growth without heroic effort. The immigration medical exam niche taps a specific Houston demographic that competitors often ignore.
For a physician buyer, the operator advantage is real: step into the clinical seat, absorb the owner compensation add-back, and you are buying your own job plus a profitable book of patients. The 1,500 square foot four-room footprint is cheap to run and leaves nearby expansion space available, which keeps fixed costs low relative to collections.

How to improve it

Extend operating hours and add evening or weekend urgent care coverage to capture walk-in volume that currently walks past to competitors. Urgent care visits carry higher per-visit revenue and require no scheduling infrastructure, so incremental hours drop quickly to the bottom line. This is the single fastest lever given the four-room capacity is likely underutilized outside core hours.
Add a nurse practitioner or physician assistant to increase throughput without adding a full physician salary. Mid-level providers let the practice see more patients per exam room and protect physician time for higher-acuity, higher-margin work. This directly addresses the capacity ceiling in a 1,500 square foot facility with only four rooms.
Aggressively market the immigration medical examination line, which is a differentiated, largely cash or self-pay service with strong margins in a diverse Houston market. Build referral relationships with immigration attorneys and community organizations to create a steady inbound pipeline. This service is discretionary-proof because it is mandated by process, not by economic conditions.
Introduce X-ray or ultrasound in-house, subject to regulatory feasibility, to keep imaging revenue and referrals inside the practice rather than leaking to outside providers. Ancillary imaging improves both patient convenience and per-visit revenue capture. Model the capital cost against the incremental billing before committing.
Tighten point-of-care testing and in-office procedure volume by training front-desk and clinical staff to identify eligible services at intake. Small procedures and POC testing carry high margins and require no new equipment beyond what a lab-certified practice already has. Standardizing capture protocols can meaningfully lift revenue per encounter.
Build formal referral relationships with nearby specialists, hospitals, and community groups to increase both new-patient flow and downstream ancillary revenue. A structured referral network stabilizes patient acquisition beyond word of mouth. This also strengthens the practice's competitive position as Houston's market grows.
Audit and renegotiate commercial payer contracts to ensure reimbursement rates are at or above market for the region. With 71% of revenue coming from commercial payers, even a few points of rate improvement compounds directly into cash flow. Most small practices under-negotiate these contracts and leave money on the table.

Diligence notes

Reconcile the two profit figures the broker discloses: net income of approximately $189,000 versus SDE of $594,000. The $405,000 gap is presumably physician owner compensation and other add-backs, and a buyer must confirm exactly what is added back and whether those add-backs survive under new ownership. A non-physician buyer who must hire a doctor is buying $189,000 of income, not $594,000, which changes the multiple dramatically.
Verify the revenue and growth claims with actual tax returns, payer remittances, and monthly collections reports, since gross revenue is listed as Not Disclosed in the structured fields but cited as roughly $1.2 million in the narrative. Confirm the near 12% year-over-year growth is organic and not driven by a one-time volume spike such as immigration exam surges. Trace collections, not just billings, given healthcare AR timing.
Confirm the payer mix (71% commercial) with a payer-level breakdown of collections over 24 months, because payer concentration and reimbursement trends drive the entire valuation. Understand which specific commercial plans dominate and whether any single payer represents concentration risk. Also assess Medicare reimbursement exposure to potential rate changes.
Investigate how dependent patient loyalty and volume are on the departing physician, since a multigenerational patient base often follows the doctor, not the brand. Quantify what portion of visits are tied to the current owner's personal relationships and what a transition or retention plan looks like. No seller transition support was disclosed, so this handover risk needs to be priced in directly.
Review the lease terms on the 1,500 square foot facility, including remaining term, renewal options, rent escalators, and the availability and cost of the nearby expansion space referenced in the listing. A short remaining lease or an uncooperative landlord could cap the growth thesis. Confirm the location assignment transfers cleanly at close.
Confirm all clinical credentials, CLIA lab certification, licensing, malpractice history, and any open regulatory or billing compliance issues, since healthcare practices carry meaningful compliance liability. Review the immigration medical examiner designation to ensure it transfers or can be re-established under new ownership. Audit coding practices to rule out over-billing exposure that could surface post-close.

Source

Originally listed on BizBuySell. View original listing →