﻿<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.irs.gov/efile" returnVersion="2023v5.1">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2024-10-15T09:19:30-05:00</ReturnTs>
    <TaxPeriodEndDt>2023-12-31</TaxPeriodEndDt>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2023-01-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>741078510</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>TEXAS MEDICAL ASSOCIATION</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>TEXA</BusinessNameControlTxt>
      <PhoneNum>5123701300</PhoneNum>
      <USAddress>
        <AddressLine1Txt>401 WEST 15TH ST 100</AddressLine1Txt>
        <CityNm>AUSTIN</CityNm>
        <StateAbbreviationCd>TX</StateAbbreviationCd>
        <ZIPCd>78701</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>MICHAEL DARROUZET</PersonNm>
      <PersonTitleTxt>EVP/CEO</PersonTitleTxt>
      <PhoneNum>5123701300</PhoneNum>
      <SignatureDt>2024-10-14</SignatureDt>
    </BusinessOfficerGrp>
    <IRSResponsiblePrtyInfoCurrInd>0</IRSResponsiblePrtyInfoCurrInd>
    <TaxYr>2023</TaxYr>
    <BuildTS>2024-10-15 13:58:12Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="8">
    <IRS990 documentId="RetDoc1038000001" referenceDocumentId="RetDoc1044400001">
      <PrincipalOfficerNm>MICHAEL DARROUZET</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>401 WEST 15TH ST 100</AddressLine1Txt>
        <CityNm>AUSTIN</CityNm>
        <StateAbbreviationCd>TX</StateAbbreviationCd>
        <ZIPCd>78701</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>35967608</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>0</GroupReturnForAffiliatesInd>
      <Organization501cInd organization501cTypeTxt="6">X</Organization501cInd>
      <WebsiteAddressTxt>WWW.TEXMED.ORG</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1853</FormationYr>
      <LegalDomicileStateCd>TX</LegalDomicileStateCd>
      <ActivityOrMissionDesc>EMPOWERING TEXAS PHYSICIANS IN THE PRACTICE OF MEDICINE.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>18</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>18</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>153</TotalEmployeeCnt>
      <TotalVolunteersCnt>1300</TotalVolunteersCnt>
      <TotalGrossUBIAmt>1036107</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>228479</NetUnrelatedBusTxblIncmAmt>
      <PYContributionsGrantsAmt>1829980</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>1873095</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>19191833</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>18386428</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>1387158</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>4515253</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>3933089</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>3829306</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>26342060</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>28604082</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>737846</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>697291</CYGrantsAndSimilarPaidAmt>
      <PYBenefitsPaidToMembersAmt>0</PYBenefitsPaidToMembersAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>16481726</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>17007306</CYSalariesCompEmpBnftPaidAmt>
      <PYTotalProfFndrsngExpnsAmt>0</PYTotalProfFndrsngExpnsAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>7769821</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>8069789</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>24989393</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>25774386</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>1352667</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>2829696</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>58758669</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>61919602</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>19452687</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>20024055</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>39305982</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>41895547</NetAssetsOrFundBalancesEOYAmt>
      <InfoInScheduleOPartIIIInd>X</InfoInScheduleOPartIIIInd>
      <MissionDesc>TMA STRIVES TO IMPROVE THE HEALTHCARE OF ALL TEXANS, TO FEDERATE THE PROFESSION LICENSED TO PRACTICE MEDICINE AND SURGERY WITHIN TEXAS, TO PROVIDE EFFECTIVE REPRESENTATION FOR ITS MEMBERS, TO UNITE WITH SIMILIAR STATE ASSOCIATIONS, TO PROMOTE UNITY AND COOPERATION FOR ITS MEMBERS AND COMPONENT ORGANIZATIONS, TO SECURE ENACTMENT OF APPROPRIATE MEDICAL AND HEALTH CARE LEGISLATION, TO EXTEND MEDICAL KNOWLEDGE AND ADVANCE MEDICAL SCIENCE, AND TO STRIVE FOR THE PREVENTION AND CURE OF DISEASE AND THE IMPROVEMENT OF PUBLIC HEALTH.</MissionDesc>
      <SignificantNewProgramSrvcInd>0</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>0</SignificantChangeInd>
      <Desc>DIVISIONS OF ADVOCACY, MEDICAL ECONOMICS, AND COMMUNICATIONS AND THE OFFICE OF THE GENERAL COUNSEL WORK ON STATE AND NATIONAL ADVOCACY ISSUES THAT IMPACT PHYSICIAN VIABILITY AND THEIR PATIENTS' ACCESS TO CARE. THIS INCLUDES EDUCATING MEMBERS ABOUT THE LEGAL, REGULATORY, AND LEGISLATIVE ISSUES IMPACTING THE MEDICAL LANDSCAPE, THEN EMPLOYING STRATEGIC ADVOCACY EFFORTS TO REMOVE BARRIERS SO PHYSICIANS CAN DO WHAT THEY DO BEST - CARE FOR PATIENTS. THIS WORK AFFECTS ALL TEXAS PHYSICIANS.</Desc>
      <ProgSrvcAccomActy2Grp>
        <Desc>OFFICE OF THE GENERAL COUNSEL AND DIVISION OF MEDICAL ECONOMICS WORK YEAR-ROUND TO PROTECT PHYSICIAN PRACTICE VIABILITY AND REMOVE EXISTING BARRIERS AFFECTING PHYSICIANS' ABILITY TO CARE FOR PATIENTS. THIS WORK ENTAILS FOUR SUCCESSFUL LAWSUITS AGAINST THE FEDERAL GOVERNMENT AND CONTINUED WORK TO ENSURE REGULATORY RULES PROTECT PHYSICIANS AND PATIENTS.</Desc>
      </ProgSrvcAccomActy2Grp>
      <ProgSrvcAccomActy3Grp>
        <Desc>DIVISIONS OF MEMBERSHIP EXPERIENCE/MARKETING AND COMMUNICATIONS HAVE EMPLOYED NEW DIGITAL MARKETING TACTICS TO RETAIN THE ASSOCIATION'S CURRENT MEMBERSHIP OF 57,820 PHYSICIANS AND MEDICAL STUDENTS, AND TO INCREASE THE ASSOCIATION'S MARKET SHARE BY RECRUITING NEW MEMBERS. NEW INVESTMENTS IN TECHNOLOGY AND SEGMENTED MARKET STRATEGIES HAVE YIELDED RESULTS.</Desc>
      </ProgSrvcAccomActy3Grp>
      <DescribedInSection501c3Ind>0</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="RetDoc1234500001">1</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd referenceDocumentId="RetDoc1039700001">0</PoliticalCampaignActyInd>
      <SubjectToProxyTaxInd referenceDocumentId="RetDoc1039700001">1</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="RetDoc1040000001">0</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="RetDoc1040000001">0</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="RetDoc1040000001">1</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="RetDoc1040000001">0</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd>0</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="RetDoc1040000001">1</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="RetDoc1040000001">0</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="RetDoc1040000001">0</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="RetDoc1040000001">0</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc1040000001">1</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc1040000001">1</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">0</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">1</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>0</SchoolOperatingInd>
      <ForeignOfficeInd>0</ForeignOfficeInd>
      <ForeignActivitiesInd>0</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>0</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>0</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>0</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>0</FundraisingActivitiesInd>
      <GamingActivitiesInd>0</GamingActivitiesInd>
      <OperateHospitalInd>0</OperateHospitalInd>
      <GrantsToOrganizationsInd referenceDocumentId="RetDoc1041900001">1</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd referenceDocumentId="RetDoc1041900001">1</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentId="RetDoc1042400001">1</ScheduleJRequiredInd>
      <TaxExemptBondsInd>0</TaxExemptBondsInd>
      <LoanOutstandingInd>0</LoanOutstandingInd>
      <GrantToRelatedPersonInd>0</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>0</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>0</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>0</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd>0</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>0</DeductibleArtContributionInd>
      <TerminateOperationsInd>0</TerminateOperationsInd>
      <PartialLiquidationInd>0</PartialLiquidationInd>
      <DisregardedEntityInd referenceDocumentId="RetDoc1043400001">1</DisregardedEntityInd>
      <RelatedEntityInd referenceDocumentId="RetDoc1043400001">1</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>1</RelatedOrganizationCtrlEntInd>
      <TransactionWithControlEntInd referenceDocumentId="RetDoc1043400001">1</TransactionWithControlEntInd>
      <ActivitiesConductedPrtshpInd referenceDocumentId="RetDoc1043400001">0</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>1</ScheduleORequiredInd>
      <IRPDocumentCnt>72</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>1</BackupWthldComplianceInd>
      <EmployeeCnt>153</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>1</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>1</UnrelatedBusIncmOverLimitInd>
      <Form990TFiledInd>1</Form990TFiledInd>
      <ForeignFinancialAccountInd>0</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>0</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>0</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>0</NondeductibleContributionsInd>
      <IndoorTanningServicesInd>0</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>0</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>0</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>18</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>18</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>0</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>0</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>0</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>0</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>1</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>1</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>0</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>1</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>1</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>0</OfficerMailingAddressInd>
      <LocalChaptersInd>0</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>1</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>1</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>1</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>1</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>1</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>1</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>1</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>1</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>0</InvestmentInJointVentureInd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <BusinessName>
          <BusinessNameLine1Txt>STEPHEN DAVIS</BusinessNameLine1Txt>
        </BusinessName>
        <PhoneNum>5123701490</PhoneNum>
        <USAddress>
          <AddressLine1Txt>401 WEST 15TH ST STE 100</AddressLine1Txt>
          <CityNm>AUSTIN</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>78701</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>RICHARD W SNYDER II MD</PersonNm>
        <TitleTxt>PRES(23-24)/PRES-ELECT(22-23)</TitleTxt>
        <AverageHoursPerWeekRt>13.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>133333</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>GARY W FLOYD MD</PersonNm>
        <TitleTxt>PRES(22-23)/IMMED PAST PRES(23-24)</TitleTxt>
        <AverageHoursPerWeekRt>9.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>66667</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>E LINDA VILLARREAL MD</PersonNm>
        <TitleTxt>IMMED PAST PRES(22-23)</TitleTxt>
        <AverageHoursPerWeekRt>3.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>G RAY CALLAS MD</PersonNm>
        <TitleTxt>PRES-ELECT(23-24)/CHAIR (22-23)</TitleTxt>
        <AverageHoursPerWeekRt>3.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>4000</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MICHELLE A BERGER MD</PersonNm>
        <TitleTxt>SECRETARY/TREASURER(22-23)</TitleTxt>
        <AverageHoursPerWeekRt>3.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>GREGORY M FULLER MD</PersonNm>
        <TitleTxt>SECRETARY/TREASURER(23-24)</TitleTxt>
        <AverageHoursPerWeekRt>3.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>BRADFORD W HOLLAND MD</PersonNm>
        <TitleTxt>SPEAKER OF THE HOUSE</TitleTxt>
        <AverageHoursPerWeekRt>3.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JOHN G FLORES MD</PersonNm>
        <TitleTxt>VICE SPEAKER OF THE HOUSE</TitleTxt>
        <AverageHoursPerWeekRt>3.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KEITH A BOURGEOIS MD</PersonNm>
        <TitleTxt>CHAIR (23-24)/VICE CHAIR (22-23)</TitleTxt>
        <AverageHoursPerWeekRt>3.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>6000</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JOSEPH S VALENTI MD</PersonNm>
        <TitleTxt>VICE CHAIR (23-24)/TRUSTEE (22-23)</TitleTxt>
        <AverageHoursPerWeekRt>3.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JAYESH B SHAH MD</PersonNm>
        <TitleTxt>SECRETARY (23-24)/TRUSTEE (22-23)</TitleTxt>
        <AverageHoursPerWeekRt>3.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JOHN T CARLO MD</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LISA L EHRLICH MD</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CYNTHIA A JUMPER MD</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KIMBERLY E MONDAY MD</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>BRADFORD S PATT MD</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>TONY R AVENTA MD</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SAMUEL E MATHIS MD</PersonNm>
        <TitleTxt>YOUNG PHYSICIAN MBR</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ALIXANDRIA F PFEIFFER DO</PersonNm>
        <TitleTxt>RESIDENT/FELLOW MBR (22-23)</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SUBHAN TABBA MD</PersonNm>
        <TitleTxt>RESIDENT/FELLOW MBR (23-24)</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ABHISHEK DHARAN</PersonNm>
        <TitleTxt>MEDICAL STUDENT MBR (22-23)</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KATHERINE RUSSELL</PersonNm>
        <TitleTxt>MEDICAL STUDENT MBR (23-24)</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MICHAEL J DARROUZET</PersonNm>
        <TitleTxt>EVP/CEO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>2.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>598400</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>45810</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JOHN E DORMAN</PersonNm>
        <TitleTxt>COO</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>10.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>464190</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>114400</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>78010</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KELLY WALLA</PersonNm>
        <TitleTxt>VP/GENERAL COUNSEL</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>449080</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>56332</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CLAYTON STEWART</PersonNm>
        <TitleTxt>VP, PUBLIC AFFAIRS</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>293802</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>40310</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KAREN G BATORY</PersonNm>
        <TitleTxt>VP, POPULATION HEALTH &amp; MEDICAL EDUCATION</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>254560</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>60112</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>GARY A ATWOOD</PersonNm>
        <TitleTxt>VP, TIS &amp; ADMINISTRATIVE SERVICES</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>239810</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>60112</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>PAMELA UDALL</PersonNm>
        <TitleTxt>VP, COMMUNICATIONS &amp; MARKETING</TitleTxt>
        <AverageHoursPerWeekRt>40.00</AverageHoursPerWeekRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>245091</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>48267</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>2754933</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>114400</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>388953</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>65</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>RAND CONSTRUCTION CORPORATION</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>2815 EXPOSITION BLVD STE 100</AddressLine1Txt>
            <CityNm>AUSTIN</CityNm>
            <StateAbbreviationCd>TX</StateAbbreviationCd>
            <ZIPCd>78703</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>RENOVATION CONSTRUCTION</ServicesDesc>
        <CompensationAmt>955745</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>MENTE SOWELL ARCHITECTS INC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>5901 OLD FREDERICKSBURG RD STE B102</AddressLine1Txt>
            <CityNm>AUSTIN</CityNm>
            <StateAbbreviationCd>TX</StateAbbreviationCd>
            <ZIPCd>78749</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>ARCHITECTURE/CONSTRUCTION ADMINISTRATION</ServicesDesc>
        <CompensationAmt>568163</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>FREEMAN AUDIO VISUAL INC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>3801 ADLER DR STE 150</AddressLine1Txt>
            <CityNm>DALLAS</CityNm>
            <StateAbbreviationCd>TX</StateAbbreviationCd>
            <ZIPCd>75211</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>AUDIO VISUAL SERVICES</ServicesDesc>
        <CompensationAmt>263936</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>SEVENTH SPECTRUM STUDIOS</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>5901 OLD FREDERICKSBURG RD STE B103</AddressLine1Txt>
            <CityNm>AUSTIN</CityNm>
            <StateAbbreviationCd>TX</StateAbbreviationCd>
            <ZIPCd>78749</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>DESIGN SERVICES</ServicesDesc>
        <CompensationAmt>248664</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>PROFESSIONAL JANITORIAL SERVICE</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1304 WEST OLTORF ST</AddressLine1Txt>
            <CityNm>AUSTIN</CityNm>
            <StateAbbreviationCd>TX</StateAbbreviationCd>
            <ZIPCd>78704</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>JANITORIAL SERVICES</ServicesDesc>
        <CompensationAmt>202026</CompensationAmt>
      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>12</CntrctRcvdGreaterThan100KCnt>
      <RelatedOrganizationsAmt>1223914</RelatedOrganizationsAmt>
      <AllOtherContributionsAmt>649181</AllOtherContributionsAmt>
      <TotalContributionsAmt>1873095</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>MEMBERSHIP DUES</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>16196324</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>16196324</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>SERVICES BILLED</Desc>
        <BusinessCd>561000</BusinessCd>
        <TotalRevenueColumnAmt>1599669</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>739638</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>339600</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>520431</ExclusionAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>CONFERENCES</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>339740</TotalRevenueColumnAmt>
        <ExclusionAmt>339740</ExclusionAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>EDUCATIONAL PROGRAMS</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>210233</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>210233</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>PUBLICATIONS</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>40462</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>40462</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>18386428</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>1449351</TotalRevenueColumnAmt>
        <ExclusionAmt>1449351</ExclusionAmt>
      </InvestmentIncomeGrp>
      <RoyaltiesRevenueGrp>
        <TotalRevenueColumnAmt>2444965</TotalRevenueColumnAmt>
        <ExclusionAmt>2444965</ExclusionAmt>
      </RoyaltiesRevenueGrp>
      <GrossRentsGrp>
        <RealAmt>1724776</RealAmt>
      </GrossRentsGrp>
      <LessRentalExpensesGrp>
        <RealAmt>1076295</RealAmt>
      </LessRentalExpensesGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>648481</RealAmt>
      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>648481</TotalRevenueColumnAmt>
        <UnrelatedBusinessRevenueAmt>191633</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>456848</ExclusionAmt>
      </NetRentalIncomeOrLossGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>9311133</SecuritiesAmt>
        <OtherAmt>42000</OtherAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>5972934</SecuritiesAmt>
        <OtherAmt>314297</OtherAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>3338199</SecuritiesAmt>
        <OtherAmt>-272297</OtherAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>3065902</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>3065902</RelatedOrExemptFuncIncomeAmt>
      </NetGainOrLossInvestmentsGrp>
      <OtherRevenueMiscGrp>
        <Desc>ADVERTISING</Desc>
        <BusinessCd>541800</BusinessCd>
        <TotalRevenueColumnAmt>430040</TotalRevenueColumnAmt>
        <UnrelatedBusinessRevenueAmt>205070</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>224970</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>COMPUTER HOSTING SVCS</Desc>
        <BusinessCd>518210</BusinessCd>
        <TotalRevenueColumnAmt>152900</TotalRevenueColumnAmt>
        <UnrelatedBusinessRevenueAmt>152900</UnrelatedBusinessRevenueAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueMiscGrp>
        <Desc>PRAC MGMT CONSULTING</Desc>
        <BusinessCd>541900</BusinessCd>
        <TotalRevenueColumnAmt>146904</TotalRevenueColumnAmt>
        <UnrelatedBusinessRevenueAmt>146904</UnrelatedBusinessRevenueAmt>
      </OtherRevenueMiscGrp>
      <MiscellaneousRevenueGrp>
        <TotalRevenueColumnAmt>6016</TotalRevenueColumnAmt>
        <ExclusionAmt>6016</ExclusionAmt>
      </MiscellaneousRevenueGrp>
      <OtherRevenueTotalAmt>735860</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>28604082</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>20252559</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>1036107</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>5442321</ExclusionAmt>
      </TotalRevenueGrp>
      <GrantsToDomesticOrgsGrp>
        <TotalAmt>658391</TotalAmt>
      </GrantsToDomesticOrgsGrp>
      <GrantsToDomesticIndividualsGrp>
        <TotalAmt>38900</TotalAmt>
      </GrantsToDomesticIndividualsGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>3132847</TotalAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>10421309</TotalAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>1352570</TotalAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>1180910</TotalAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>919670</TotalAmt>
      </PayrollTaxesGrp>
      <FeesForServicesLegalGrp>
        <TotalAmt>164946</TotalAmt>
      </FeesForServicesLegalGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>41461</TotalAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesLobbyingGrp>
        <TotalAmt>443000</TotalAmt>
      </FeesForServicesLobbyingGrp>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>106267</TotalAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>320240</TotalAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>38203</TotalAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>1032106</TotalAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>1266889</TotalAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>953269</TotalAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>637598</TotalAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>1642611</TotalAmt>
      </ConferencesMeetingsGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>893342</TotalAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>154303</TotalAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>OTHER EXPENSE</Desc>
        <TotalAmt>198346</TotalAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>DUES AND SUBSCRIPTIONS</Desc>
        <TotalAmt>96580</TotalAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>UNRELATED BUSINESS INCO</Desc>
        <TotalAmt>47981</TotalAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>EMPLOYEE CONTINUING EDU</Desc>
        <TotalAmt>32647</TotalAmt>
      </OtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>25774386</TotalAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>3128054</BOYAmt>
        <EOYAmt>458535</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>5665717</BOYAmt>
        <EOYAmt>4054443</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
        <BOYAmt>695046</BOYAmt>
        <EOYAmt>1177203</EOYAmt>
      </AccountsReceivableGrp>
      <OthNotesLoansReceivableNetGrp>
        <BOYAmt>2836</BOYAmt>
        <EOYAmt>1366</EOYAmt>
      </OthNotesLoansReceivableNetGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>5642549</BOYAmt>
        <EOYAmt>5922185</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>24611402</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>14924044</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>8092163</BOYAmt>
        <EOYAmt>9687358</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>35532304</BOYAmt>
        <EOYAmt>40618512</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <TotalAssetsGrp>
        <BOYAmt>58758669</BOYAmt>
        <EOYAmt>61919602</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>3071311</BOYAmt>
        <EOYAmt>3428185</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <DeferredRevenueGrp>
        <BOYAmt>10769305</BOYAmt>
        <EOYAmt>10561641</EOYAmt>
      </DeferredRevenueGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>5612071</BOYAmt>
        <EOYAmt>6034229</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>19452687</BOYAmt>
        <EOYAmt>20024055</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>39285299</BOYAmt>
        <EOYAmt>41875823</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <DonorRestrictionNetAssetsGrp>
        <BOYAmt>20683</BOYAmt>
        <EOYAmt>19724</EOYAmt>
      </DonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>39305982</BOYAmt>
        <EOYAmt>41895547</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>58758669</BOYAmt>
        <EOYAmt>61919602</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
      <ReconcilationRevenueExpnssAmt>2829696</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>-240135</NetUnrlzdGainsLossesInvstAmt>
      <OtherChangesInNetAssetsAmt>4</OtherChangesInNetAssetsAmt>
      <InfoInScheduleOPartXIIInd>X</InfoInScheduleOPartXIIInd>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <ConsolidatedBasisFinclStmtInd>X</ConsolidatedBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>0</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleB documentId="RetDoc1234500001">
      <ContributorInformationGrp>
        <ContributorNum>RESTRICTED</ContributorNum>
        <ContributorBusinessName>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorBusinessName>
        <ContributorUSAddress>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorUSAddress>
        <TotalContributionsAmt>RESTRICTED</TotalContributionsAmt>
      </ContributorInformationGrp>
    </IRS990ScheduleB>
    <IRS990ScheduleC documentId="RetDoc1039700001">
      <SubstantiallyAllDuesNondedInd>0</SubstantiallyAllDuesNondedInd>
      <OnlyInHouseLobbyingInd>0</OnlyInHouseLobbyingInd>
      <AgreeCarryoverPriorYearInd>1</AgreeCarryoverPriorYearInd>
      <DuesAssessmentsAmt>16196324</DuesAssessmentsAmt>
      <NonDeductibleLbbyngPltclCYAmt>2224369</NonDeductibleLbbyngPltclCYAmt>
      <NonDeductibleLbbyngPltclTotAmt>2224369</NonDeductibleLbbyngPltclTotAmt>
      <AggregateReportedDuesNtcAmt>1943559</AggregateReportedDuesNtcAmt>
      <CarriedOverAmt>280810</CarriedOverAmt>
    </IRS990ScheduleC>
    <IRS990ScheduleD documentId="RetDoc1040000001">
      <SolicitedAssetsSaleInd>0</SolicitedAssetsSaleInd>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>24611402</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>14924044</DepreciationAmt>
        <BookValueAmt>9687358</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>9687358</TotalBookValueLandBuildingsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>INVESTMENTS HELD FOR RELATED ORGS</Desc>
        <Amt>1089700</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>DUES PAYABLE</Desc>
        <Amt>-2802</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>DEFERRED COMPENSATION</Desc>
        <Amt>4835198</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>OTHER</Desc>
        <Amt>112133</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>6034229</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART X, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION ACCOUNTS FOR UNCERTAIN TAX POSITIONS BASED ON A MORE-LIKELY-THAN-NOT THRESHOLD FOR THE RECOGNITION AND DE-RECOGNITION OF TAX POSITIONS, WHICH INCLUDES THE ACCOUNTING FOR INTEREST AND PENALTIES RELATING TO TAX POSITIONS. THE ORGANIZATION DOES NOT CURRENTLY HAVE ANY MATERIAL TAX POSITIONS MANAGEMENT CONSIDERS UNCERTAIN AT DECEMBER 31, 2023.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleI documentId="RetDoc1041900001">
      <GrantRecordsMaintainedInd>1</GrantRecordsMaintainedInd>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>TEXAS MEDICAL ASSOCIATION FOUNDATION</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>401 WEST 15TH ST</AddressLine1Txt>
          <CityNm>AUSTIN</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>78701</ZIPCd>
        </USAddress>
        <RecipientEIN>746073346</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>230182</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>OPERATING EXPENSE SUPPORT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>TEXAS MEDICAL ASSOCIATION SPECIAL FUNDS FOUNDATION</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>401 WEST 15TH ST</AddressLine1Txt>
          <CityNm>AUSTIN</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>78701</ZIPCd>
        </USAddress>
        <RecipientEIN>742749879</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>131662</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>PUBLIC HEALTH PROGRAM SUPPORT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>TEXAS MEDICAL ASSOCIATION ALLIANCE</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>401 WEST 15TH ST</AddressLine1Txt>
          <CityNm>AUSTIN</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>78701</ZIPCd>
        </USAddress>
        <RecipientEIN>746050698</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>112195</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>OPERATING EXPENSE SUPPORT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>TEXAS MEDICAL ASSOCIATION LIBRARY</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>401 WEST 15TH ST</AddressLine1Txt>
          <CityNm>AUSTIN</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>78701</ZIPCd>
        </USAddress>
        <RecipientEIN>237042275</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>97042</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>OPERATING EXPENSE SUPPORT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>BEXAR COUNTY MEDICAL LIBRARY ASSOCIATION</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>4334 N LOOP 1604 2ND FLOOR</AddressLine1Txt>
          <CityNm>SAN ANTONIO</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>78721</ZIPCd>
        </USAddress>
        <RecipientEIN>740510530</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>7000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>PUBLIC HEALTH PROGRAM SUPPORT</PurposeOfGrantTxt>
      </RecipientTable>
      <Total501c3OrgCnt>5</Total501c3OrgCnt>
      <TotalOtherOrgCnt>0</TotalOtherOrgCnt>
      <GrantsOtherAsstToIndivInUSGrp>
        <GrantTypeTxt>SCIENCE TEACHING AWARD</GrantTypeTxt>
        <RecipientCnt>3</RecipientCnt>
        <CashGrantAmt>32000</CashGrantAmt>
      </GrantsOtherAsstToIndivInUSGrp>
      <GrantsOtherAsstToIndivInUSGrp>
        <GrantTypeTxt>HEALTH JOURNALISM AWARD</GrantTypeTxt>
        <RecipientCnt>10</RecipientCnt>
        <CashGrantAmt>5000</CashGrantAmt>
      </GrantsOtherAsstToIndivInUSGrp>
      <GrantsOtherAsstToIndivInUSGrp>
        <GrantTypeTxt>MEDIA AWARD JUDGE STIPEND</GrantTypeTxt>
        <RecipientCnt>4</RecipientCnt>
        <CashGrantAmt>400</CashGrantAmt>
      </GrantsOtherAsstToIndivInUSGrp>
      <GrantsOtherAsstToIndivInUSGrp>
        <GrantTypeTxt>EVENT SPONSORSHIP</GrantTypeTxt>
        <RecipientCnt>2</RecipientCnt>
        <CashGrantAmt>1500</CashGrantAmt>
      </GrantsOtherAsstToIndivInUSGrp>
    </IRS990ScheduleI>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <ClubDuesOrFeesInd>X</ClubDuesOrFeesInd>
      <WrittenPolicyRefTAndEExpnssInd>1</WrittenPolicyRefTAndEExpnssInd>
      <SubstantiationRequiredInd>1</SubstantiationRequiredInd>
      <CompensationCommitteeInd>X</CompensationCommitteeInd>
      <IndependentConsultantInd>X</IndependentConsultantInd>
      <WrittenEmploymentContractInd>X</WrittenEmploymentContractInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>0</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>0</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>0</EquityBasedCompArrngmInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JOHN E DORMAN</PersonNm>
        <TitleTxt>COO</TitleTxt>
        <BaseCompensationFilingOrgAmt>415000</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>114400</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>250</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>48940</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>65200</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>12810</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>542200</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>114400</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MICHAEL J DARROUZET</PersonNm>
        <TitleTxt>EVP/CEO</TitleTxt>
        <BaseCompensationFilingOrgAmt>567000</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>31400</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>33000</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>12810</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>644210</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>KELLY WALLA</PersonNm>
        <TitleTxt>VP/GENERAL COUNSEL</TitleTxt>
        <BaseCompensationFilingOrgAmt>410000</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>15000</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>24080</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>43500</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>12832</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>505412</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>CLAYTON STEWART</PersonNm>
        <TitleTxt>VP, PUBLIC AFFAIRS</TitleTxt>
        <BaseCompensationFilingOrgAmt>275000</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>16322</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>2480</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>27500</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>12810</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>334112</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>KAREN G BATORY</PersonNm>
        <TitleTxt>VP, POPULATION HEALTH &amp; MEDICAL EDUC</TitleTxt>
        <BaseCompensationFilingOrgAmt>236900</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>1000</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>16660</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>47380</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>12732</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>314672</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>GARY A ATWOOD</PersonNm>
        <TitleTxt>VP, TIS &amp; ADMINISTRATIVE SERVICES</TitleTxt>
        <BaseCompensationFilingOrgAmt>236900</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>250</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>2660</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>47380</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>12732</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>299922</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>PAMELA UDALL</PersonNm>
        <TitleTxt>VP, COMMUNICATIONS &amp; MARKETING</TitleTxt>
        <BaseCompensationFilingOrgAmt>236900</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>5711</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>2480</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>35535</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>12732</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>293358</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990 SCHEDULE J PART II LINE (1)(II)</FormAndLineReferenceDesc>
        <ExplanationTxt>RELATED ORGANIZATION COMPENSATION OF $114,000 PAID TO JOHN E DORMAN BY THE PHYSICIANS FOUNDATION INC. THIS AMOUNT INCLUDED BASE COMPENSATION OF $114,000 FOR CONTRACTED PROFESSIONAL SERVICES.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>TEXAS MEDICAL ASSOCIATION IS A PROFESSIONAL ASSOCIATION REPRESENTING TEXAS PHYSICIANS AND MEDICAL STUDENTS. AT 12/31/23, THE ASSOCIATION HAD 57,820 MEMBERS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7A</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BOARD OF TRUSTEES SHALL BE COMPOSED OF NINE AT-LARGE MEMBERS AND ONE YOUNG PHYSICIAN ELECTED BY THE HOUSE OF DELEGATES, ONE RESIDENT MEMBER, ONE STUDENT MEMBER, AND, AS EX OFFICIO MEMBERS: THE PRESIDENT, PRESIDENT-ELECT, IMMEDIATE PAST PRESIDENT, SECRETARY/TREASURER, SPEAKER OF THE HOUSE OF DELEGATES, AND VICE SPEAKER OF THE HOUSE OF DELEGATES. THE HOUSE OF DELEGATES, THE LEGISLATIVE AND POLICY-MAKING BODY OF THE ASSOCIATION, SHALL ELECT THE OFFICERS EXCEPT AS OTHERWISE PROVIDED IN THE BYLAWS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>FORM 990 IS PREPARED BY THE VICE PRESIDENT OF FINANCE. PRIOR TO FILING, THE RETURN IS THOROUGHLY REVIEWED BY THE TREASURER, EXECUTIVE VICE PRESIDENT, THE CHIEF OPERATING OFFICER AND THE GENERAL COUNSEL. THE RETURN IS MADE AVAILABLE TO ALL OFFICERS AND TRUSTEES PRIOR TO FILING.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>DISCLOSURE OF AFFILIATIONS QUESTIONNAIRE IS SUBMITTED BY ALL OFFICERS AND TRUSTEES ANNUALLY. THE CONFLICT OF INTEREST POLICY IS REVIEWED AT THE BEGINNING OF ALL BOARD MEETINGS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>INDEPENDENT COMPENSATION CONSULTANT DEVELOPS COMPENSATION STRATEGY BY EVALUATING MARKET TRENDS AND ORGANIZATIONAL GOALS/PHILOSOPHY WHILE ENSURING ONGOING COMPETITIVENESS AND COMPLIANCE. THIS RECOMMENDATION IS PRESENTED TO THE ASSOCIATION'S COMPENSATION COMMITTEE FOR REVIEW. FINAL PLAN IS THEN SUBMITTED TO BOARD OF TRUSTEES FOR APPROVAL.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XI, LINE 9:</FormAndLineReferenceDesc>
        <ExplanationTxt>ROUNDING 4.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990 PART XII LINE 2C</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BOARD OF TRUSTEES APPROVES SELECTION OF INDEPENDENT AUDITOR. THE ANNUAL AUDIT REPORT IS FORMALLY PRESENTED TO THE BOARD BY THE AUDIT FIRM PARTNER OR MANAGER RESPONSIBLE FOR THE ENGAGEMENT. THE BOARD MEETS WITH THE AUDITOR IN EXECUTIVE SESSION TO DISCUSS ANY QUESTIONS AND CONCERNS IN ABSENCE OF ASSOCIATION STAFF.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc1043400001">
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>TMA PRACTICE MANAGEMENT HOLDINGS LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>401 WEST 15TH ST</AddressLine1Txt>
          <CityNm>AUSTIN</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>78701</ZIPCd>
        </USAddress>
        <EIN>814734874</EIN>
        <PrimaryActivitiesTxt>ACCOUNTABLE CARE ORGANIZATION DEVELOPMENT (INACTIVE)</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>TX</LegalDomicileStateCd>
        <TotalIncomeAmt>0</TotalIncomeAmt>
        <EndOfYearAssetsAmt>120000</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>TEXAS MEDICAL ASSOCIATION</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>TMA SPECIALTY SERVICES LLC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>401 WEST 15TH ST</AddressLine1Txt>
          <CityNm>AUSTIN</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>78701</ZIPCd>
        </USAddress>
        <EIN>823596032</EIN>
        <PrimaryActivitiesTxt>VALUE BASED CARE ADVISORY SERVICES (INACTIVE)</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>TX</LegalDomicileStateCd>
        <TotalIncomeAmt>0</TotalIncomeAmt>
        <EndOfYearAssetsAmt>533526</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>TMA PRACTICE MANAGEMENT HOLDINGS LLC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>DR S E THOMPSON SCHOLARSHIP FUND</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>401 WEST 15TH ST</AddressLine1Txt>
          <CityNm>AUSTIN</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>78701</ZIPCd>
        </USAddress>
        <EIN>746047346</EIN>
        <PrimaryActivitiesTxt>MEDICAL STUDENT LOAN FUND</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>TX</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>509(A)(3) TYPE 1</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>TEXAS MEDICAL ASSOCIATION</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>MAY OWEN IRREVOCABLE TRUST</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>401 WEST 15TH ST</AddressLine1Txt>
          <CityNm>AUSTIN</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>78701</ZIPCd>
        </USAddress>
        <EIN>237377962</EIN>
        <PrimaryActivitiesTxt>MEDICAL STUDENT LOAN FUND</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>TX</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>509(A)(3) TYPE 1</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>TEXAS MEDICAL ASSOCIATION</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>ANNIE LEE THOMPSON LIBRARY TRUST FUND</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>401 WEST 15TH ST</AddressLine1Txt>
          <CityNm>AUSTIN</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>78701</ZIPCd>
        </USAddress>
        <EIN>746087355</EIN>
        <PrimaryActivitiesTxt>MEDICAL LIBRARY SUPPORT</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>TX</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>509(A)(3) TYPE 1</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>TEXAS MEDICAL ASSOCIATION</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>TEXAS MEDICAL ASSOCIATION LIBRARY</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>401 WEST 15TH ST</AddressLine1Txt>
          <CityNm>AUSTIN</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>78701</ZIPCd>
        </USAddress>
        <EIN>237042275</EIN>
        <PrimaryActivitiesTxt>MEDICAL LIBRARY SUPPORT</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>TX</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>509(A)(3) TYPE 1</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>TEXAS MEDICAL ASSOCIATION</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>PHYSICIANS BENEVOLENT FUND</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>401 WEST 15TH ST</AddressLine1Txt>
          <CityNm>AUSTIN</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>78701</ZIPCd>
        </USAddress>
        <EIN>746050660</EIN>
        <PrimaryActivitiesTxt>PROVIDE SUPPORT TO INDIGENT PHYSICIANS AND DISASTER RELIEF TO PHYSICIANS</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>TX</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>509(A)(3) TYPE 1</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>TEXAS MEDICAL ASSOCIATION</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>TEXAS MEDICAL ASSOCIATION SPECIAL FUNDS FOUNDATION</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>401 WEST 15TH ST</AddressLine1Txt>
          <CityNm>AUSTIN</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>78701</ZIPCd>
        </USAddress>
        <EIN>742749879</EIN>
        <PrimaryActivitiesTxt>MEDICAL STUDENT LOAN FUNDS</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>TX</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>509(A)(3) TYPE 1</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>TEXAS MEDICAL ASSOCIATION</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>TEXAS MEDICAL ASSOCIATION POLITICAL ACTION COMMITTEE</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>401 WEST 15TH ST</AddressLine1Txt>
          <CityNm>AUSTIN</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>78701</ZIPCd>
        </USAddress>
        <EIN>741482481</EIN>
        <PrimaryActivitiesTxt>POLITICAL ACTION COMMITTEE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>TX</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>527</ExemptCodeSectionTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>TEXAS MEDICAL ASSOCIATION</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>TEXAS MEDICAL ASSOCIATION FOUNDATION</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>401 WEST 15TH ST</AddressLine1Txt>
          <CityNm>AUSTIN</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>78701</ZIPCd>
        </USAddress>
        <EIN>746073346</EIN>
        <PrimaryActivitiesTxt>PROVIDE SUPPORT TO PUBLIC HEALTH, EDUCATION AND MEDICAL PROGRAMS</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>TX</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>170(B)(1)(A)(VI)</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>TEXAS MEDICAL ASSOCIATION</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>TEXAS MEDICAL ASSOCIATION ALLIANCE</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>401 WEST 15TH ST</AddressLine1Txt>
          <CityNm>AUSTIN</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>78701</ZIPCd>
        </USAddress>
        <EIN>746050698</EIN>
        <PrimaryActivitiesTxt>SPONSOR AND SUPPORT PROGRAMS TO ADVANCE MEDICINE AND PUBLIC HEALTH</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>TX</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(6)</ExemptCodeSectionTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>THE PHYSICIAN'S FOUNDATION INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>401 WEST 15TH ST</AddressLine1Txt>
          <CityNm>AUSTIN</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>78701</ZIPCd>
        </USAddress>
        <EIN>200914085</EIN>
        <PrimaryActivitiesTxt>AWARDS AND GRANTS TO PHYSICIAN ORGANIZATIONS</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>FL</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>509(A)(3) TYPE 1</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>TEXAS MEDICAL ASSOCIATION INSURANCE TRUST</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>401 WEST 15TH ST</AddressLine1Txt>
          <CityNm>AUSTIN</CityNm>
          <StateAbbreviationCd>TX</StateAbbreviationCd>
          <ZIPCd>78701</ZIPCd>
        </USAddress>
        <EIN>746128660</EIN>
        <PrimaryActivitiesTxt>INSURANCE SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>TX</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>TEXAS MEDICAL ASSOCIATION</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>1</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>1</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>1</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>0</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>0</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>1</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>0</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>1</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>0</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>1</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>1</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>1</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>1</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>DR SE THOMPSON SCHOLARSHIP FUND</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>A</TransactionTypeTxt>
        <InvolvedAmt>32945</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>DR SE THOMPSON SCHOLARSHIP FUND</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>J</TransactionTypeTxt>
        <InvolvedAmt>8893</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>DR SE THOMPSON SCHOLARSHIP FUND</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>L</TransactionTypeTxt>
        <InvolvedAmt>158104</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>DR SE THOMPSON SCHOLARSHIP FUND</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>O</TransactionTypeTxt>
        <InvolvedAmt>260287</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>DR SE THOMPSON SCHOLARSHIP FUND</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>Q</TransactionTypeTxt>
        <InvolvedAmt>447478</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MAY OWEN IRREVOCABLE TRUST</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>A</TransactionTypeTxt>
        <InvolvedAmt>17524</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MAY OWEN IRREVOCABLE TRUST</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>J</TransactionTypeTxt>
        <InvolvedAmt>4730</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MAY OWEN IRREVOCABLE TRUST</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>L</TransactionTypeTxt>
        <InvolvedAmt>78527</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MAY OWEN IRREVOCABLE TRUST</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>O</TransactionTypeTxt>
        <InvolvedAmt>136994</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>MAY OWEN IRREVOCABLE TRUST</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>Q</TransactionTypeTxt>
        <InvolvedAmt>365538</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>ANNIE LEE THOMPSON LIBRARY TRUST FUND</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>C</TransactionTypeTxt>
        <InvolvedAmt>77085</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>ANNIE LEE THOMPSON LIBRARY TRUST FUND</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>L</TransactionTypeTxt>
        <InvolvedAmt>100685</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>ANNIE LEE THOMPSON LIBRARY TRUST FUND</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>N</TransactionTypeTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>ANNIE LEE THOMPSON LIBRARY TRUST FUND</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>Q</TransactionTypeTxt>
        <InvolvedAmt>188491</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>TEXAS MEDICAL ASSOCIATION LIBRARY</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>B</TransactionTypeTxt>
        <InvolvedAmt>97042</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>TEXAS MEDICAL ASSOCIATION LIBRARY</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>C</TransactionTypeTxt>
        <InvolvedAmt>52513</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>TEXAS MEDICAL ASSOCIATION LIBRARY</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>L</TransactionTypeTxt>
        <InvolvedAmt>72472</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>TEXAS MEDICAL ASSOCIATION LIBRARY</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>N</TransactionTypeTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>TEXAS MEDICAL ASSOCIATION LIBRARY</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>Q</TransactionTypeTxt>
        <InvolvedAmt>120899</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>PHYSICIANS BENEVOLENT FUND</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>A</TransactionTypeTxt>
        <InvolvedAmt>19627</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>PHYSICIANS BENEVOLENT FUND</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>J</TransactionTypeTxt>
        <InvolvedAmt>5377</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>PHYSICIANS BENEVOLENT FUND</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>L</TransactionTypeTxt>
        <InvolvedAmt>113922</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>PHYSICIANS BENEVOLENT FUND</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>O</TransactionTypeTxt>
        <InvolvedAmt>195247</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>PHYSICIANS BENEVOLENT FUND</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>Q</TransactionTypeTxt>
        <InvolvedAmt>370619</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>TEXAS MEDICAL ASSN SPECIAL FUNDS FNDTN</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>B</TransactionTypeTxt>
        <InvolvedAmt>131662</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>TEXAS MEDICAL ASSN SPECIAL FUNDS FNDTN</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>C</TransactionTypeTxt>
        <InvolvedAmt>75000</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>TEXAS MEDICAL ASSN SPECIAL FUNDS FNDTN</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>L</TransactionTypeTxt>
        <InvolvedAmt>77686</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>TEXAS MEDICAL ASSN SPECIAL FUNDS FNDTN</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>N</TransactionTypeTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>TEXAS MEDICAL ASSN SPECIAL FUNDS FNDTN</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>P</TransactionTypeTxt>
        <InvolvedAmt>394810</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>TEXAS MEDICAL ASSN POLITICAL ACTION CMTE</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>L</TransactionTypeTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>TEXAS MEDICAL ASSN POLITICAL ACTION CMTE</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>N</TransactionTypeTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>TEXAS MEDICAL ASSOCIATION FOUNDATION</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>A</TransactionTypeTxt>
        <InvolvedAmt>52413</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>TEXAS MEDICAL ASSOCIATION FOUNDATION</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>B</TransactionTypeTxt>
        <InvolvedAmt>230182</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>TEXAS MEDICAL ASSOCIATION FOUNDATION</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>C</TransactionTypeTxt>
        <InvolvedAmt>290256</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>TEXAS MEDICAL ASSOCIATION FOUNDATION</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>L</TransactionTypeTxt>
        <InvolvedAmt>80000</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>TEXAS MEDICAL ASSOCIATION FOUNDATION</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>Q</TransactionTypeTxt>
        <InvolvedAmt>482633</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>TEXAS MEDICAL ASSOCIATION ALLIANCE</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>B</TransactionTypeTxt>
        <InvolvedAmt>112195</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>TEXAS MEDICAL ASSOCIATION ALLIANCE</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>L</TransactionTypeTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>TEXAS MEDICAL ASSOCIATION ALLIANCE</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>O</TransactionTypeTxt>
        <InvolvedAmt>102719</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>TEXAS MEDICAL ASSOCIATION ALLIANCE</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>Q</TransactionTypeTxt>
        <InvolvedAmt>52423</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>THE PHYSICIANS FOUNDATION INC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>L</TransactionTypeTxt>
        <InvolvedAmt>119000</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>THE PHYSICIANS FOUNDATION INC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>Q</TransactionTypeTxt>
        <InvolvedAmt>23462</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>TEXAS MEDICAL ASSOCIATION INSURANCE TRUST</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>A</TransactionTypeTxt>
        <InvolvedAmt>447494</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>TEXAS MEDICAL ASSOCIATION INSURANCE TRUST</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>C</TransactionTypeTxt>
        <InvolvedAmt>743060</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>TEXAS MEDICAL ASSOCIATION INSURANCE TRUST</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>L</TransactionTypeTxt>
        <InvolvedAmt>313431</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>TEXAS MEDICAL ASSOCIATION INSURANCE TRUST</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>Q</TransactionTypeTxt>
        <InvolvedAmt>1590786</InvolvedAmt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>