Provider Demographics
NPI:1447538855
Name:GLEAVES, ASHLEY WOLODZKO (MD)
Entity type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:WOLODZKO
Last Name:GLEAVES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1355 CENTRAL PKWY S STE 400
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-5057
Mailing Address - Country:US
Mailing Address - Phone:210-653-5501
Mailing Address - Fax:
Practice Address - Street 1:502 MADISON OAK DR STE 240
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4086
Practice Address - Country:US
Practice Address - Phone:210-495-1900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-02
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ6194207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX356966702Medicaid