Established Gastroenterology Practice & ASC - East Texas, CRE Included
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Established gastroenterology practice (1992), its co-located Medicare-certified ambulatory surgery center (2006), and the purpose-built building that houses both, offered together at $10,000,000. Everything conveys debt-free. No notes, no equipment leases, no lines of credit, and the real estate has been owned free and clear for more than twenty years.
Lender pre-qualified: an SBA 7(a) plus conventional financing structure for this transaction has been reviewed by a national lender and a pre-approval letter is on file. A buyer still qualifies individually, but the deal itself has already been through underwriting review. Seller financing is available for the right offer. A minimum of $1 million of liquidity is expected to be contributed to the transaction. Asset or equity structures are both open, the real estate is available as unencumbered collateral, and the continuing physician is open to a minority equity rollover as part of the right transaction.
The Company is the only ambulatory-surgery-based GI provider for a wide, multi-county rural catchment. A regional hospital sits in immediate proximity, referral relationships are long established, and there is no website and no marketing spend. Referrals arrive on their own.
Two revenue lines come from the same physicians in the same building: professional fees through the practice and facility fees through the ASC. Combined revenue ran $4.6M to $5.0M in each of 2023, 2024, and 2025 per filed federal returns. ASC facility revenue reached an all-time high in 2025 and first-half 2026 is running stronger still. Adjusted EBITDA before any physician compensation ran $2.85M to $3.3M a year over 2022 through 2025.
The EBITDA figure of $2,350,000 is that same measure after $700,000 of physician replacement compensation for both physicians, at the terms the current physicians have indicated in principle. Cash flow (SDE) of $2,700,000 is the identical measure stated before compensation to one working physician owner, which is the convention where a buyer intends to practice in the business. At market (MGMA) compensation of $600,000 per physician, EBITDA is approximately $1,850,000. Every scenario is laid out line by line in the CIM, and every number traces to a filed return.
Payer mix is roughly 59% commercial, 25% traditional Medicare, 9% VA and government, 6% Medicare Advantage, and 1% self-pay, with no Medicaid. Commercial rates have not been renegotiated in more than ten years.
Succession is planned. One founding physician retires after a defined transition; the other intends to stay long term in a clinical role and to help onboard a recruited associate. Post-close employment terms are open and are part of the negotiation. Tenured staff and an outside CPA run scheduling, billing, collections, and administration. The physicians do not run the office.
Texas does not allow non-physicians to own a medical practice, so the practice entity itself must be held by a Texas-licensed physician. The surgery center, the real estate, and the management company carry no such restriction, and a non-physician buyer can hold the practice through a management services (MSO) structure with a physician owner. The sellers are open to that structure.
Process: NDA, buyer qualification (biography, personal financial statement with proof of funds, lender pre-qualification or funding letter), then the CIM. A written, non-binding Indication of Interest is what opens the data room and access to management. There is no submission deadline; indications are reviewed as they are received, and a call can be requested by email at any point in the process.
Location and identity are disclosed to qualified buyers only. All inquiries go through IC-USA. No contact with the business, its physicians, or its staff.
Lender pre-qualified: an SBA 7(a) plus conventional financing structure for this transaction has been reviewed by a national lender and a pre-approval letter is on file. A buyer still qualifies individually, but the deal itself has already been through underwriting review. Seller financing is available for the right offer. A minimum of $1 million of liquidity is expected to be contributed to the transaction. Asset or equity structures are both open, the real estate is available as unencumbered collateral, and the continuing physician is open to a minority equity rollover as part of the right transaction.
The Company is the only ambulatory-surgery-based GI provider for a wide, multi-county rural catchment. A regional hospital sits in immediate proximity, referral relationships are long established, and there is no website and no marketing spend. Referrals arrive on their own.
Two revenue lines come from the same physicians in the same building: professional fees through the practice and facility fees through the ASC. Combined revenue ran $4.6M to $5.0M in each of 2023, 2024, and 2025 per filed federal returns. ASC facility revenue reached an all-time high in 2025 and first-half 2026 is running stronger still. Adjusted EBITDA before any physician compensation ran $2.85M to $3.3M a year over 2022 through 2025.
The EBITDA figure of $2,350,000 is that same measure after $700,000 of physician replacement compensation for both physicians, at the terms the current physicians have indicated in principle. Cash flow (SDE) of $2,700,000 is the identical measure stated before compensation to one working physician owner, which is the convention where a buyer intends to practice in the business. At market (MGMA) compensation of $600,000 per physician, EBITDA is approximately $1,850,000. Every scenario is laid out line by line in the CIM, and every number traces to a filed return.
Payer mix is roughly 59% commercial, 25% traditional Medicare, 9% VA and government, 6% Medicare Advantage, and 1% self-pay, with no Medicaid. Commercial rates have not been renegotiated in more than ten years.
Succession is planned. One founding physician retires after a defined transition; the other intends to stay long term in a clinical role and to help onboard a recruited associate. Post-close employment terms are open and are part of the negotiation. Tenured staff and an outside CPA run scheduling, billing, collections, and administration. The physicians do not run the office.
Texas does not allow non-physicians to own a medical practice, so the practice entity itself must be held by a Texas-licensed physician. The surgery center, the real estate, and the management company carry no such restriction, and a non-physician buyer can hold the practice through a management services (MSO) structure with a physician owner. The sellers are open to that structure.
Process: NDA, buyer qualification (biography, personal financial statement with proof of funds, lender pre-qualification or funding letter), then the CIM. A written, non-binding Indication of Interest is what opens the data room and access to management. There is no submission deadline; indications are reviewed as they are received, and a call can be requested by email at any point in the process.
Location and identity are disclosed to qualified buyers only. All inquiries go through IC-USA. No contact with the business, its physicians, or its staff.
About the Business
- Years in Operation
- 34
- Employees
- 20 (17 Full-time, 3 Contractors)
- Facilities & Assets
- Approximately 8,400 square feet, purpose-built and ASC-grade, in the community's medical district with a regional hospital in immediate proximity. The building houses the clinic, a Medicare-certified endoscopy suite operated as a separately licensed ASC, and an on-site histology area where biopsy specimens are prepared before being sent out for pathologist reading. It is owned free and clear by a real estate partnership included in the sale; the original mortgage was retired more than twenty years ago. Clinical and office equipment, including endoscopy and procedural equipment, is functional and maintained but largely depreciated for tax purposes, and none of it is financed or under capital lease. A broker's opinion of value places the real estate at $0.9M to $1.5M; replacement cost for an ASC-grade build of this size would exceed that range. No independent appraisal has been obtained to date.
- Market Outlook / Competition
- The Company is the only ambulatory-surgery-based GI provider in its catchment. The nearest alternatives are either solo, clinic-based practices without a GI-dedicated surgery center of their own, or groups in distant metro markets that do not realistically serve this population. That makes the Company the default destination for GI referrals across a wide radius, reinforced by entrenched relationships with the nearby hospital and with smaller facilities in surrounding counties. Texas does not require a Certificate of Need to open an ASC, so the barrier here is not regulatory. It is economic: the capital to build and equip a surgery center, the licensing and CMS certification timeline, and, above all, the difficulty of recruiting gastroenterologists to non-metropolitan East Texas. Demand is durable and demographic: an aging population, the screening-colonoscopy age lowered to 45, and the continued shift of procedures out of hospital outpatient departments into lower-cost ASC settings.
- Opportunities for Growth
- None of the following is in the historical numbers. Commercial rates have not been renegotiated in over ten years on a book that is roughly 59% commercial, and nobody on staff owns payer contracting today. The facility's clinic and procedure-room layout can support up to four gastroenterologists against the two practicing now, adding revenue on both the professional and facility lines, and a recruited associate is already contemplated in the succession plan. The physicians wound down after-hours hospital call coverage during 2025 and stopped entirely at the start of 2026; the Company's CPA estimates that work historically produced roughly $300,000 a year, and a new physician team could take it back on. Infusion is billed through the practice today only incidentally, so the credentialing and billing pathway exists and there is space for a dedicated suite. Extended hours and added procedure capacity are available inside the existing footprint.
Real Estate
- Owned or Leased
- Owned
- Included in asking price
- Building Sq. Ft.
- 8,400
About the Sale
- Seller Motivation
- Founding physician retirement and planned succession
- Transition Support
- Both founding physicians will support a defined transition, with specific terms negotiable alongside the transaction. One intends to retire after that transition; the other intends to remain long term in a purely clinical role and to supervise a recruited associate, which carries clinical leadership, referral relationships, and patient continuity through the handoff and past it. Both have indicated in principle a willingness to enter two- to three-year post-close employment agreements; nothing has been executed, and terms are open. The office manager has more than fifteen years of tenure across both entities, and a retention arrangement is contemplated. Because tenured staff and an outside CPA already run scheduling, billing, collections, and administration, what transfers here is clinical capacity rather than operating knowledge.
- Financing Options
- SBA 7(a)+conventional pre-vetted. Assets convey debt-free. Seller financing available
Listing Info
- ID
- 2548480
- Listing Views
- 18
Attached DocumentsAttachment Disclaimer
Listing ID: 2548480 The information on this listing has been provided by either the seller or a business broker representing the seller. BizQuest has no interest or stake in the sale of this business and has not verified any of the information and assumes no responsibility for its accuracy, veracity, or completeness. See our full Terms of Use. Learn how to avoid scams.
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