MEDICARE: FAMILY EYE CARE SPECIALISTS PLLC

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	152W00000X	Optometrist

General Provider Information

NPI Number	:	1366305609
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY EYE CARE SPECIALISTS PLLC

Provider Business Mailing Address
First Line	:	1906 FAIRVIEW AVE STE 100
Second Line	:
City	:	CALDWELL
State	:	ID
Zip	:	83605-5433
Country	:	US
Telephone Number	:	208-459-2020
Fax Number	:	208-459-2034

Provider Business Practice Location Address
First Line	:	1906 FAIRVIEW AVE STE 100
Second Line	:
City	:	CALDWELL
State	:	ID
Zip	:	83605-5433
Country	:	US
Telephone Number	:	208-459-2020
Fax Number	:	208-459-2034

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DOUGLAS WAYNE ADAMS
Credential	:
Telephone Number	:	208-459-2020

Provider Enumeration Date	:	12/04/2025
Last Update Date	:	12/04/2025

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