San Antonio Business Brokers Who Sit With You Before They Sell For You.

Karen’s family migrated to San Antonio from East Texas in the 1970s on the back of an SA-area opportunity that has anchored her family ever since. Her father became a Lackland civilian engineer; her mother spent decades as a Wilford Hall Medical Center nurse, working second-shift through Karen’s high school years and putting both daughters through college on a single hospital salary. Karen finished UT Health San Antonio School of Medicine in 1996, completed internal medicine residency at University Hospital, and opened her practice in the Live Oak and Northeast San Antonio submarket in 2003 with two exam rooms and one nurse. Twenty-three years later, the operation runs as Karen plus two other internists plus one nurse practitioner, supported by 18 W-2 staff. The service mix landed at 55 percent traditional internal medicine and adult primary care, 22 percent chronic care management and remote patient monitoring (a Medicare Advantage growth line that compounded steadily across the past five years), 15 percent in-office procedures, and 8 percent women’s adult preventive wellness. CHRISTUS and University Hospital privileges were active on every clinician. The payer mix landed in the texture the Northeast SA submarket actually demands: roughly 28 percent commercial, 25 percent TRICARE (the large military-retiree base in the NE SA neighborhoods around Universal City and Live Oak shows up directly here), 22 percent Medicare Advantage, 18 percent traditional Medicare, and the remainder split across smaller payers. Revenue cleared $5.6 million at a 27 percent EBITDA margin, defensibly clean for a 3-physician primary-care group of that size. Karen had been recruited as Associate Dean at UT Health San Antonio School of Medicine, an academic-and-administrative role that does not allow her to keep running a private practice. Her husband (a Lackland civilian engineer) is supportive; their daughter is in dental school at SMU; their son finished Howard Law and works at a Dallas firm.

Primary-care PE rollup is hot across Texas’s NE SA TRICARE-heavy submarkets, and the buyer profile reflects it. Karen had been approached six times in eighteen months: twice by national primary-care platform consolidators, twice by Texas-aligned PE platforms, once by a CHRISTUS-aligned VBC platform, and once by a strategic acquirer running a TRICARE-and-VA expansion thesis. None of those scouts had walked her through how a buyer’s diligence team would price the military-retiree TRICARE concentration, the chronic care management revenue line, or her senior nurse practitioner Tanisha Brooks’s quiet but real institutional weight inside the practice. She called us the week after she signed her acceptance for the Associate Dean role at UT Health.

The first call ran forty-eight minutes. Karen walked us through the founding, the way the chronic care management and remote patient monitoring line had grown from a small clinical interest into the practice’s most differentiated revenue line, the way Tanisha, a African-American SA-native NP who had been with the practice since 2008, had quietly become the institutional voice on the chronic-care floor, and the conversations she had been having with the other clinicians about whether they wanted to stay through a change of control. The valuation walkthrough showed Karen a band that priced the TRICARE military-retiree base, the Medicare Advantage chronic-care management revenue, the in-office procedure suite utilization, the CHRISTUS and University Hospital privilege continuity, the regional referral pull from primary-care groups across NE SA, and Tanisha’s continuity at the chronic-care layer. The valuation also flagged what the diligence file would need: a payer-mix-by-physician waterfall with full hospital-privilege documentation, a CCM and RPM utilization breakout with attribution to the primary attending, named-physician retention agreements with the other two internists, a named-NP retention agreement with Tanisha, and a clean breakout of in-office procedure revenue versus pure cognitive-visit revenue. Karen spent five months getting that done. The CGK San Antonio team took the practice to market.

NE SA primary-care draws a deep buyer pool. The blind teaser drew deep buyer interest. The pool was the structural mix the primary-care industry tends to attract in SA’s TRICARE-heavy submarkets: a few HNW physician-investor buyers, search funders, independent sponsors, the heaviest concentration of bidders from mid-market PE primary-care platform consolidators (the dominant cohort, since primary-care PE rollup is a hot active thesis in Texas TRICARE markets), CHRISTUS-aligned and University Health-aligned VBC-thesis platforms, regional medical-group rollups across TX, OK, NM, and AZ, and a couple of Texas family offices with healthcare-services theses. Four LOIs advanced to a final round. Karen chose the second-highest headline because the buyer (a PE-backed primary-care platform consolidator with a Texas-and-Sun-Belt thesis and TRICARE network alignment, with 25-plus primary-care groups in their existing portfolio across TX, OK, NM, and AZ, sponsored by a Dallas mid-market PE fund) committed to keeping all 18 staff and all three clinicians under their current contracts, kept the Live Oak office, and named Karen as senior medical advisor for 18 months at one day per week. The deal closed at 80 percent cash at close, 8 percent in a twelve-month escrow for general indemnity, and 12 percent rolled forward as equity in the platform’s holding company. When the wire cleared Karen called her mother from her Live Oak office. Her mother, the seventy-nine-year-old retired Wilford Hall nurse who had carried a hospital ICU through two decades of night shifts, said quietly “Your daddy would be proud.” Karen walked the practice with Tanisha, the two of them standing for a long moment at the chronic-care suite door.

“I needed a buyer who would ask about Tanisha first. The number came after that.”

Karl’s German-Texan family reaches five generations into the Hill Country. His great-great-grandfather emigrated from Bavaria in 1854 with the wave of German Catholics and Lutherans who founded Boerne, Comfort, Fredericksburg, and the broader Hill Country settlement. Four generations of the family have worked Boerne-area construction trades; Karl came up through his father’s small masonry business, retrained as a roofing contractor in the late 1990s, and opened his own roofing firm in 2002 out of a shop on the east side of Boerne. By the time he called us, the operation ran as a residential and small-commercial roofing contractor serving the Boerne, Fair Oaks Ranch, and northwestern Bexar County submarkets at $1.4 million in revenue and a 27 percent SDE margin, with a six-person staff of Karl plus four roofing crew plus one office manager. The specialty mix landed on standing-seam metal and tile roofing for Hill Country custom homes (the segment most Hill Country roofers cannot execute cleanly), plus small commercial work for the Boerne and Fair Oaks Ranch commercial real estate. About 140 active customers were on file, with roughly 35 replacement-roof installs per year plus a steady book of repair and inspection work. Karl’s son chose to coach high school football for Boerne ISD and is not taking the family business; his daughter is a UT Austin nursing student. Karl’s wife, a retired Boerne ISD teacher, is ready for them to spend more time at the family Hill Country property south of Comfort. Karl wants to phase down to part-time consulting while remaining nearby.

Roofing M&A at this tier has its own structural pattern. The valuable assets are the customer file, the standing-seam metal and tile specialty (which most regional roofers cannot execute), the crew continuity through the change of control, and the Boerne-and-Fair-Oaks-Ranch reputation that has built up over twenty-three years. Smaller-tier home-services contractors typically transact on a cash-and-seller-note basis rather than the cash-plus-rollover structure that dominates larger home-services platform deals. Karl had been approached four times in eighteen months: twice by national home-services rollup platforms, once by a Texas regional consolidator running a Hill Country thesis, and once by an HNW operator-buyer in his early 40s who had been quietly running diligence across small Texas roofing books. None of those conversations had walked Karl through how a buyer’s diligence team would price the standing-seam metal and tile specialty premium, the customer-file retention pattern, or how the crew continuity through Javier, his lead Mexican-American crew leader since 2002, would be priced inside an LOI. He called us the week his wife told him she was ready for the slower pace at the Comfort property.

The first call ran twenty-nine minutes. Karl walked us through the founding, the way the standing-seam metal and tile specialty had compounded into the segment that defended the firm’s pricing power, the way Javier, a longtime Mexican-American crew leader who had been with him since the 2002 founding, had quietly become the institutional voice on the roofing crew, and the conversations he had been having with Javier about whether Javier wanted to stay through a change of control. The valuation walkthrough showed Karl a band that priced the customer file by repair-versus-replacement category, the standing-seam metal and tile specialty as a premium segment, the small-commercial book mix, the crew continuity through Javier, and the Boerne and Fair Oaks Ranch reputation. The valuation also flagged what the diligence file would need: a customer-file revenue waterfall by repair, replacement, and inspection category; a standing-seam-and-tile install schedule covering the trailing eighteen months; a named-crew retention agreement with Javier; a clean shop-lease-assignment opinion; and a small-commercial backlog schedule. Karl spent five weeks getting that done. The CGK San Antonio team took the firm to market.

Smaller-tier roofing M&A in the Hill Country draws a moderate pool with a strong HNW operator-buyer cohort. The blind teaser drew deep buyer interest. The pool was the structural mix the smallest-tier roofing band tends to attract: a few HNW operator-buyers (including the early-40s Texas home-services operator who had approached him directly, plus two other owner-operators looking for a turnkey Hill Country roofing book), a small handful of search funders (roofing is starting to attract search funders), independent sponsors, regional home-services consolidators, mid-market PE home-services rollup platforms with Texas focus, and one strategic acquirer with a Hill Country roofing thesis. All five LOIs advanced to a final round at Karl’s tier. Karl chose the highest headline because the buyer (an HNW operator-buyer in his early 40s, a former Texas home-services operator with a San Antonio family-office co-investor) kept the family name on the trucks, kept all six staff with comp-step protections, kept Javier in his crew-leader seat at his existing comp tier, named Karl as transition advisor for 12 months, and committed to keeping the Boerne shop. The deal closed structured as 78 percent cash at close with the remaining 22 percent as a seller note over three years at a market rate. When the wire cleared Karl called his wife from the Boerne shop. She had been waiting for the call all morning and simply said “We’re going to Comfort.” Karl walked across the shop to Javier, who had been with him since the 2002 founding, and shook his hand on the shop floor.

“Five generations of Boerne. The buyer kept the name on the trucks. That is the inheritance.”