The health tourism industry, as one of the dynamic and economic sectors globally, plays a significant role in regional development. Yazd Province, with its advanced medical centers and cultural attractions, holds high potential to become a hub for health tourism. This study aimed to evaluate the efficiency and productivity of active medical centers in health tourism in Yazd Province using Network Data Envelopment Analysis (DEA) and the Organizational Excellence (EFQM) approach. The research method was mixed (qualitative-quantitative), and the statistical population consisted of 10 active medical centers in this field. Data were collected through questionnaires and interviews with experts and analyzed using SPSS and MaxDEA software. The findings revealed that the average overall efficiency of the centers was 0.74, with only three centers achieving full efficiency. The two-stage network analysis revealed that the main bottleneck of inefficiency lies in the international attraction and marketing stage (with an average efficiency of 0.62), whereas the treatment service delivery stage (with an average of 0.93) enjoyed high efficiency. Furthermore, a significant correlation was observed between the strength of EFQM enablers and the operational efficiency of the centers. Efficient centers benefited from clear strategies, standardized processes, and strong partnership networks. In contrast, inefficient centers largely lacked strategic plans and specialized human resources in international marketing. The study's results emphasize the necessity of a fundamental revision of international marketing strategies, development of partnership networks, strengthening of international patient liaison units, and specialization of centers based on comparative advantages. These findings can guide managers and policymakers in enhancing the competitiveness of health tourism in Yazd Province.