# UNIVERSITY DRIVE HEALTH CENTER, P.A.

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

## Provider details

- **NPI number:** 1649289711
- **Authorized official:** DR. WILLIAM WAYNE HAIRSTON D. O. (OWNER/ PRESIDENT)
- **Authorized official phone:** (936) 564-1188

## Contact information

- **Practice address:** 932 N UNIVERSITY DR, NACOGDOCHES, TX 75961-4643
- **Practice address phone:** (936) 564-1188
- **Practice address fax:** (936) 560-4137
- **Mailing address:** 932 N UNIVERSITY DR, NACOGDOCHES, TX 75961-4643
- **Mailing address phone:** (936) 564-1188
- **Mailing address fax:** (936) 560-4137

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/06/2006
- **Last updated:** 07/06/2010