Healthcare Provider Details

I. General information

NPI: 1114800448
Provider Name (Legal Business Name): VERISOLA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2025
Last Update Date: 07/25/2025
Certification Date: 07/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 WILCREST DR, STE 300 OFFICE 35
HOUSTON TX
77042-2752
US

IV. Provider business mailing address

2500 WILCREST DR, STE 300 OFFICE 35
HOUSTON TX
77042-2752
US

V. Phone/Fax

Practice location:
  • Phone: 945-293-3746
  • Fax: 945-293-3778
Mailing address:
  • Phone: 945-293-3746
  • Fax: 945-293-3778

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BD1200X
TaxonomyDialysis Equipment & Supplies (DME)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: NIKOLAI BUZOLIN
Title or Position: PRESIDENT
Credential:
Phone: 945-293-3746