Provider Demographics
NPI:1073849394
Name:EL FUTURO, INC.
Entity Type:Organization
Organization Name:EL FUTURO, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:LUCAS
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-338-1939
Mailing Address - Street 1:2020 CHAPEL HILL RD STE 23
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-1186
Mailing Address - Country:US
Mailing Address - Phone:919-688-7101
Mailing Address - Fax:919-688-7102
Practice Address - Street 1:2020 CHAPEL HILL RD.
Practice Address - Street 2:STE 23
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707
Practice Address - Country:US
Practice Address - Phone:919-688-7101
Practice Address - Fax:919-688-7102
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EL FUTURO, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-10-21
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5905592Medicaid