# SA-OMS SPECIALISTS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518642487
- **Authorized official:** DR. SEAN RATHBURN DDS (MANAGER)
- **Authorized official phone:** (903) 908-0977

## Contact information

- **Practice address:** 3015 GREEN MEADOW DR, SAN ANGELO, TX 76904-6975
- **Practice address phone:** (325) 949-1288
- **Mailing address:** 3015 GREEN MEADOW DR, SAN ANGELO, TX 76904-6975
- **Mailing address phone:** (903) 908-0977

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | — | NULL | Yes |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | — | — | Yes |

## Other

- **Enumeration date:** 06/19/2023
- **Last updated:** 07/10/2023