MEDICARE: CRYSTAL WINONA SORENSEN MORRIS D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	27348	TX

General Provider Information

NPI Number	:	1801178561
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRYSTAL WINONA SORENSEN MORRIS D.D.S.

Provider Business Mailing Address
First Line	:	2211 RAYFORD RD STE 111-336
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77386-1555
Country	:	US
Telephone Number	:	801-656-8516
Fax Number	:	801-656-8516

Provider Business Practice Location Address
First Line	:	2211 RAYFORD RD STE 111-336
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77386-1555
Country	:	US
Telephone Number	:	801-656-8516
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/19/2011
Last Update Date	:	04/14/2026

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