General Internal Medicine Physicians Salary in Irving, TX (2026)

The Figure Your Offer Letter Leaves Out

Your $249,868 salary in Irving doesn't buy what $249,868 buys in the average American city. That's a $7,278 annual gap. Your effective purchasing power drops to $242,590—meaning you're actually $4,400 behind the national average for this role, even though your gross number looks higher.

Irving's cost of living index sits at 103. That's a 3% premium over the national baseline. It's not catastrophic. It's not Houston or Dallas proper. But it's real, and it compounds.

The Mistake Candidates Keep Making

You're comparing yourself to the national average of $245,450 and thinking you're winning. You're not. You're losing $4,400 in purchasing power before you even sign the lease.

Most physicians in Irving assume the salary gap is offset by lower housing costs. It isn't. Texas has no state income tax—that's real. But Irving's housing market has tightened. A three-bedroom in a decent neighborhood runs $1,800–$2,200 monthly. That's $21,600–$26,400 annually. Add utilities, insurance, and a car payment in a sprawling metro, and your fixed costs consume 35–40% of gross income before taxes.

If you're a General Internal Medicine Physician earning $249,868 in Irving, here's what your Tuesday actually looks like: You take home roughly $16,500 monthly after federal and FICA taxes. Your mortgage or rent is $1,900. Insurance, utilities, and car payment: $1,200. Groceries and gas: $800. You've got $12,600 left for everything else—student loans, childcare, retirement, savings. That's not tight. But it's not the cushion the headline salary suggests.

The Spread — And What Drives It

The 25th percentile earns $110,330. The 75th earns $304,839. That's a $194,509 gap—nearly 2.8x difference for the same job title in the same city.

This spread tells you something important: experience, specialization, and negotiation skill matter enormously in internal medicine. A newly graduated physician fresh from residency lands near the bottom. A physician with 10+ years, board certifications in geriatrics or palliative care, or a leadership role at a major health system lands in the upper quartile. The median sits at $227,329—$22,539 below the average, which means half the market earns less than that.

What separates p25 from p75?

• Board certifications beyond internal medicine (geriatrics, infectious disease, critical care) add $40,000–$80,000 annually
• Negotiation at hire — most physicians accept the first offer; pushing back on base salary, sign-on bonus, and loan forgiveness can shift you $15,000–$30,000 higher
• Leadership or administrative roles — medical directorships, quality committees, or EHR optimization roles command premiums of $25,000–$60,000

Benchmark: Irving vs the Country

Irving's 1.8% year-over-year growth is below the national trend for physicians (typically 2.5–3.5% annually). The Dallas-Fort Worth metro is growing, but internal medicine salaries are not keeping pace with demand. This suggests either oversupply of physicians in the region or stagnant healthcare spending. For you: expect modest raises. Don't plan on salary inflation to solve cash flow problems.

Here's What They Don't Show You

Here's the catch: Texas has no state income tax, but Irving's property taxes run 1.8–2.2% of home value annually—higher than many states with income tax. If you buy a $400,000 home, that's $7,200–$8,800 yearly in property tax alone. Healthcare costs for a family plan through most Irving employers run $8,000–$12,000 annually in premiums plus deductibles. Your $249,868 gross becomes roughly $165,000–$175,000 net after all taxes and mandatory deductions.

Should You Take the Irving Job?

• Choose Irving if: You're early-career, value stability over growth, and want to build a patient base in a growing metro without the intensity of a major teaching hospital.
• Skip Irving if: You're mid-career with negotiating power and can land a role in a higher-growth market (Austin, Denver, Nashville) where physician salaries are climbing faster than 1.8% annually.

Here's My Take

Irving pays fairly for internal medicine, but it's not a growth market for this specialty. The salary is solid, the cost of living is manageable, and Texas tax policy is genuinely advantageous—but you're not getting ahead of inflation at 1.8% growth. If you're taking this job, negotiate hard on the front end (sign-on bonus, loan forgiveness, CME allowance) because your annual raises won't move the needle. If you have other offers, compare the total compensation package, not the base salary.

Your next step: Pull the full offer letter and calculate your actual take-home using a Texas tax calculator. Then compare that number to your top 2–3 alternative offers. The winner isn't always the highest headline number.