NPI age
11 years
Enumerated 2014-10-04
● Active Type 2 · Organization
Country Club Medical Center Llc
Country Club Medical Center Llc is 1 of 12343 internal medicine organizations in Texas.
Primary specialty
Internal Medicine
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Short
Owner
Last NPPES update
2014-12-12
Source: monthly bulk 2026-05
How this organization compares
Across 12343 active internal medicine providers in Texas.
NPI age
11 years
↓ 6 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2014 → 2026
2014-10Enumerated in NPPES
2014
2026
Where they practice
Primary practice location
8041 N Mesa St, Suite B-2
El Paso, TX 799321735
Mailing address
8041 N Mesa St, Suite B-2
El Paso, TX 799321735
Authorized official
Tracy Edward Short, PA-C
Owner
📞 9154742454
Specialties
-
Internal Medicine PrimaryA physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer,...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (NM) | 00825875 | |
| 05 (TX) | 218658701 | |
| 05 (NM) | 40379761 | |
| 01 (TX) | 8A3569 | MEDICARE ID - TYPE UNSPECIFIED |
Practice context
Single-site organization. Only one practice location on file.
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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.