Organization
VIRT DERM, PLLC
Active
Other names
Virtual Dermatology
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN PHAM (MANAGING MEMBER)
(817) 718-3571
Entity
Organization
Contact information
Practice address
4516 LAKOTA TRL, MANSFIELD, TX 76063-2312
(281) 686-3665
Mailing address
4516 LAKOTA TRL, MANSFIELD, TX 76063-2312
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
07/23/2017
Last updated
07/29/2020
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