# JOHN C. HAIRSTON, M.D., P.A.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033214093
- **Authorized official:** JOHN C. HAIRSTON M.D. (CREDENTIALING SPECIALIST)
- **Authorized official phone:** (281) 313-7878

## Contact information

- **Practice address:** 16659 SOUTHWEST FWY, MEDICAL OFFICE BLDG II, STE 225, SUGAR LAND, TX 77479-2375
- **Practice address phone:** (281) 313-7878
- **Practice address fax:** (281) 313-7880
- **Mailing address:** 16659 SOUTHWEST FWY, MEDICAL OFFICE BLDG II, STE 225, SUGAR LAND, TX 77479-2375
- **Mailing address phone:** (281) 313-7878
- **Mailing address fax:** (281) 313-7880

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | L4417 | TX | Yes |

## Other

- **Enumeration date:** 09/14/2006
- **Last updated:** 05/08/2008

## 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 |