The healthcare landscape in Texas is shifting. As we move through 2026, the “Lone Star State” isn’t just growing—it’s undergoing a massive provider expansion. For Physician Assistants (PAs), this means more than just job security; it means unprecedented leverage in salary negotiations and specialty choices.

DFW Sky line

Whether you’re a recent grad or a seasoned PA-C looking for a change of pace, here are the top five Texas cities where the demand is highest and the pay is most competitive this year.

1. Dallas-Fort Worth (The Powerhouse)

The DFW Metroplex remains the crown jewel for PA careers. With a massive influx of specialized medical facilities, the competition for talent is fierce.

• Average PA Salary: $132,048
• Top Earners: $173,000+
• The Inside Track: We are seeing a massive surge in the Fort Worth Medical District. Hospitals are specifically hunting for PAs in the Cardiovascular Operating Room (CVOR) and Critical Care units. If you have experience in high-acuity settings or surgical assisting, DFW is currently offering some of the highest signing bonuses in the state.

2. Austin (The Growth Leader)

Austin isn’t just for tech anymore. The expansion of Dell Medical School and the surrounding clinical networks has sent PA demand skyrocketing.

• Average PA Salary: $132,342
• Why it’s ranking: While the cost of living has risen, the salary adjustments for healthcare providers in Austin have kept pace, making it one of the most lucrative spots for PAs in 2026.

3. Houston (The Specialist’s Hub)

Home to the world’s largest medical center, Houston is the place to be if you want to practice at the absolute top of your license.

• Average PA Salary: $129,264
• The Draw: Houston offers the most diversity in specialties. From world-class oncology at MD Anderson to cutting-edge emergency medicine, the professional development opportunities here are unmatched.

4. Plano (The High-Income Suburb)

Plano has quietly become one of the top-paying cities for PAs in Texas.

• Average PA Salary: $132,449
• The Draw: Many PAs are choosing Plano for the balance of high-end private practice opportunities and a slightly more suburban lifestyle compared to the Dallas core.

5. San Antonio (The Stability Choice)

San Antonio remains a pillar for healthcare, bolstered by its massive military medical presence (which we at PA Board especially respect).

• Average PA Salary: $124,525
• The Draw: San Antonio offers a fantastic “salary-to-cost-of-living” ratio. You get the benefits of a major metro area with significantly more affordable housing than Austin or Dallas.

The Bottom Line for 2026

The Texas provider shortage means the ball is in your court. However, navigating these listings on giant, generic job boards can be a nightmare. You need a platform that understands the specific needs of the PA community.

Ready to see who’s hiring in these top cities? [Browse the Latest Texas PA Job Listings on PA Board]

Texas Medical Board