Bookkeeping and Tax for Dallas Medical Practices
Monthly bookkeeping, payroll, and tax planning for Dallas physician practices, med spas, and direct primary care clinics. Handled remotely by enrolled agents.
What Texas Changes About Your Books
Dallas is one of the busiest places in the country to own a medical practice. It ranks among the top five markets for med spas and for concierge and direct primary care, and Texas has more direct primary care practices than any other state. Add the independent physician and surgical groups working around Medical City, the Southwestern Medical District, and the hospitals in East Dallas, and you have a lot of doctors and clinic owners running a business on top of patient care.
We work with Dallas practices remotely from our office in Lenexa, Kansas. Baker’s has handled bookkeeping, payroll, and tax since 1995, and our remote division focuses on independent medical and healthcare practices. Your books live in QuickBooks Online, payroll runs through Gusto, and tax work is handled by enrolled agents who learn how your practice earns and spends money. Texas shapes a few parts of that work in ways owners don’t always expect.
No State Income Tax
No State Income Tax
Texas doesn’t tax personal income, so for a practice owner the federal return is nearly the entire bill. That makes each federal decision count for more. Our tax planning covers S-corp election, a reasonable owner salary, retirement contributions, and equipment timing while there’s still time to act. If you moved here from another state, we handle the part-year return you may still owe there.
Texas Franchise Tax
Texas Franchise Tax
Most practice entities in Texas, including PLLCs and professional associations, fall under the franchise tax. Many smaller practices owe nothing because their revenue sits below the no-tax-due threshold, but an annual information report is still due each May. We watch your revenue against the threshold and make sure the filing doesn’t get missed.
Separate Books for Separate Entities
Separate Books for Separate Entities
Texas has strict rules about who can own a medical practice. Many Dallas med spas are split into a physician-owned medical entity and a management company, and many physician groups own their building through a separate company. Each entity gets its own books, and we reconcile what passes between them every month.
Payroll and Sales Tax
Payroll and Sales Tax
Texas payroll has no state income tax withholding, but you still owe unemployment tax through the Texas Workforce Commission. We run staff and provider payroll in Gusto, including providers who live or work in other states. If you sell skincare or other retail products, we file Texas sales tax on those sales so the deadlines stay handled.
Dallas Practices We Work With
Our Dallas clients look a lot like the city’s healthcare market. There are physicians who left a hospital system to open a membership practice in Lake Highlands or Oak Cliff, med spa owners in Uptown and Preston Center, and surgical groups that have stayed independent for decades. Most are very good at medicine and either new to the business side or tired of handling it themselves after hours.
Direct care is where we see the most new practices. Many Dallas physicians who start a direct primary care or concierge practice are running a business for the first time, with membership revenue, retail products, and payroll to figure out all at once. Our Chief Information Officer, Marc Eastin, is a practicing neurosurgeon who also owns a business. He built our systems around what a doctor’s week actually looks like.
Direct Primary Care and Concierge
Direct Primary Care and Concierge
We set up the entity, books, payroll, and software before you see your first patient. Once you’re open, we track membership revenue month by month, with annual memberships spread over the months they cover. You can see how many members it takes to pay rent, staff, and yourself.
Med Spas and Aesthetic Clinics
Med Spas and Aesthetic Clinics
Dallas has one of the most crowded med spa markets in the country, and pricing pressure is real. We show your profit per treatment after product cost and commissions. Prepaid packages and memberships are tracked as services you still owe, so a strong sales month doesn’t make the books look better than they are.
Independent Physician and Surgical Practices
Independent Physician and Surgical Practices
Primary care, dermatology, orthopedics, pain management, and other specialty groups. We check what your billing system says was collected against what reached the bank. We also calculate provider pay from your existing compensation agreements and keep separate books if the partners own the building.
Employed Physicians with Side Income
Employed Physicians with Side Income
Dallas health systems employ thousands of doctors, and many earn extra from locums shifts, expert witness work, or medical directorships. That income brings quarterly estimates and deductions a W-2 never required. Our tax services for physicians keep the side income organized and the estimates paid on time.
Common Questions About This Area
Do you have an office in Dallas?
No. Our office is in Lenexa, Kansas, and we work with Dallas practices remotely. Documents come through a secure portal, your books live in QuickBooks Online, and we meet by video when it helps. The firm has clients in nearly every state, so being down the street isn't what makes the work go well.
Texas has no state income tax. Do I still need tax planning?
Yes. With no state return, the federal return carries almost all of your tax bill, so the federal decisions matter more. We look at your entity structure, owner salary, retirement contributions, and equipment timing each year. We also keep your Texas franchise tax report on schedule.
I'm leaving a health system to open a direct primary care practice. When should I call you?
A few months before you open is ideal. We set up the business structure, books, payroll, and software so you aren't sorting it out while seeing your first patients. If you've already opened, we start where you are and clean up anything that was set up in a hurry.
Can you keep books for a med spa with a management company and a medical entity?
Yes. That structure is common in Texas. We keep separate books for each entity, track the money that moves between them, and reconcile both every month so the records hold up when anyone looks closely.
What does it cost?
Monthly bookkeeping runs $500 to $1,500 a month depending on volume and complexity. Payroll starts at $150 a month. Tax returns for the practice and owner run $2,500 to $6,000 a year. If your books are behind, catch-up is billed at 75% of the monthly fee for each month we bring current. We quote a flat rate after reviewing your practice.
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