Healthcare Provider Details

I. General information

NPI: 1710613336
Provider Name (Legal Business Name): ASHLEY DAWN MAROSKO PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2022
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 N BEDELL AVE STE A
DEL RIO TX
78840-8021
US

IV. Provider business mailing address

2201 N BEDELL AVE STE A
DEL RIO TX
78840-8021
US

V. Phone/Fax

Practice location:
  • Phone: 830-775-8700
  • Fax:
Mailing address:
  • Phone: 830-775-8700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA18122
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number4854
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: