NPI age
13 years
Enumerated 2012-06-07
● Active Type 2 · Organization
Sun City Sports Medicine And Family Clinic, PA
Sun City Sports Medicine And Family Clinic, PA is 1 of 251 family medicine organizations in Texas.
Primary specialty
Family Medicine
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Provencio
Md/owner
Last NPPES update
2024-06-18
Source: monthly bulk 2026-05
How this organization compares
Across 251 active family medicine providers in Texas.
NPI age
13 years
≈ at median (12 yr)
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2012 → 2026
2012-06Enumerated in NPPES
2012
2026
Where they practice
Primary practice location
12810 Edgemere Blvd
El Paso, TX 799384532
Mailing address
12810 Edgemere Blvd
El Paso, TX 799384532
Authorized official
Mauro Provencio
Md/owner
📞 9155253209
Individual providers at this organization
2 individual providers on file at this primary practice address.
- Mauro Provencio, M.D. Family Medicine NPI 1952560682
- Marzieh Webb, FNP-C Nurse Practitioner NPI 1366177263
Specialties
-
Family Medicine PrimaryA family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine...
Practice context
Multi-provider organization. 2 individual providers on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.