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Organization
JOHN C. HAIRSTON, M.D., P.A.
Active
Organization
JOHN C. HAIRSTON, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN C. HAIRSTON M.D. (CREDENTIALING SPECIALIST)
(281) 313-7878
Entity
Organization
Contact information
Practice address
16659 SOUTHWEST FWY, MEDICAL OFFICE BLDG II, STE 225, SUGAR LAND, TX 77479-2375
(281) 313-7878
(281) 313-7880
Mailing address
16659 SOUTHWEST FWY, MEDICAL OFFICE BLDG II, STE 225, SUGAR LAND, TX 77479-2375
(281) 313-7878
(281) 313-7880
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
L4417
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0035NX
BLUE CROSS BLUE SHIELD
TX
05
—
186303701
—
TX
01
—
4248755
BLUE LINK
TX
01
—
5472630
CIGNA
TX
01
—
DF7297
MEDICARE RAIL ROAD
TX
Enumeration date
09/14/2006
Last updated
05/08/2008
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