Provider Demographics
NPI:1710977525
Name:BLACKBOURNE, LORNE HOWAR (MD)
Entity Type:Individual
Prefix:DR
First Name:LORNE
Middle Name:HOWAR
Last Name:BLACKBOURNE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 ROUND ROCK AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-4026
Mailing Address - Country:US
Mailing Address - Phone:512-341-6612
Mailing Address - Fax:
Practice Address - Street 1:2300 ROUND ROCK AVE STE 201
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-4026
Practice Address - Country:US
Practice Address - Phone:512-341-6612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010493522086S0102X
TXP98082086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care