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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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