Healthcare Provider Details

I. General information

NPI: 1851201545
Provider Name (Legal Business Name): VIRIDIAN DERMATOLOGY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4441 W AIRPORT FWY STE 300
IRVING TX
75062-5960
US

IV. Provider business mailing address

4441 W AIRPORT FWY STE 300
IRVING TX
75062-5960
US

V. Phone/Fax

Practice location:
  • Phone: 972-200-7802
  • Fax: 972-634-7222
Mailing address:
  • Phone: 972-200-7802
  • Fax: 972-634-7222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: TANG DINH LE
Title or Position: GENERAL MANAGER
Credential: D.O
Phone: 972-200-7802