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FAMILY EYECARE SPECIALISTS, PLLC

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Company Details

Name: FAMILY EYECARE SPECIALISTS, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 15 May 2002 (23 years ago)
Financial Date End: 31 May 2026
Entity Number: 71548
Place of Formation: IDAHO
File Number: 71548
ZIP code: 83605
County: Canyon County
Principal Address: 420 E ELM ST CALDWELL, ID 83605
Mailing Address: 420 E. ELM ST. CALDWELL, ID 83605

Agent

Name Role Address
C T CORPORATION SYSTEM Agent 10020 W FAIRVIEW AVE, STE 104, BOISE, ID 83704

Member

Name Role Address Appointed On Resigned On
Douglas W. Adams Member 420 E. ELM STREET, CALDWELL, ID 83605 2023-03-08 2024-04-19
WILLIAM T BLACK Member 420 E ELM ST, CALDWELL, ID 83605 2021-04-05 2023-03-08
O.D. William T. Black Member 420 E. ELM ST., CALDWELL, ID 83605-4846 2024-04-19 No data
Douglas Adams O.D. Member 420 E. ELM ST., CALDWELL, ID 83605 2025-04-15 No data

National Provider Identifier

NPI Number:
1588840557
Certification Date:
2025-05-13

Authorized Person:

Name:
DOUGLAS ADAMS
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
152W00000X - Optometrist
Is Primary:
Yes

Contacts:

Fax:
2084592034

Form 5500 Series

Employer Identification Number (EIN):
320047366
Plan Year:
2018
Number Of Participants:
37
Sponsors Telephone Number:
Plan Year:
2017
Number Of Participants:
33
Sponsors Telephone Number:
Plan Year:
2016
Number Of Participants:
25
Sponsors Telephone Number:
Plan Year:
2015
Number Of Participants:
15
Sponsors Telephone Number:
Plan Year:
2014
Number Of Participants:
15
Sponsors Telephone Number:

Filing

Filing Name Filing Number Filing date
Registered Agent Name/Address Change (mass change) 0006271099 2025-05-27
Annual Report 0006208143 2025-04-15
Amendment to Certificate 0005993113 2024-12-03
Annual Report 0005698163 2024-04-19
Annual Report 0005223190 2023-05-04

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Date of last update: 14 Jul 2025

Sources: Idaho Secretary of State