Individual provider Active NPI

Maia Antoine

  • Family Nurse Practitioner
  • Port Arthur, TX
National Provider Identifier
1326496258
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1178741 Issued in TX
Practice address
2548 Memorial Blvd
Port Arthur, TX 77640-2825
Phone
(409) 983-1161
NPI assigned
Jun 1, 2016
Last updated
Mar 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1178741 TX Primary

Addresses

Primary practice location

2548 Memorial Blvd
Port Arthur, TX 77640-2825

Mailing address

2548 Memorial Blvd
Port Arthur, TX 77640-2825

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250520001775 TX Practitioner - Nurse Practitioner 3678099926 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1178741TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gulf Coast Health Center, Inc CurrentSince Apr 29, 2025 Accepting new patients
Gulf Coast Health Center, Inc CurrentSince Apr 29, 2025 Accepting new patients
Gulf Coast Health Center Inc Current Accepting new patients

Locations

2548 Memorial Blvd
Port Arthur, TX 77640
Phone 4099831161817

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1464739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742515200000",
    "number": "1326496258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2548 MEMORIAL BLVD",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "776402825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2548 MEMORIAL BLVD",
            "city": "PORT ARTHUR",
            "state": "TX",
            "postal_code": "776402825",
            "telephone_number": "409-983-1161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTOINE",
        "first_name": "MAIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-01",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1178741",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Arthur, TX

Sources for this page

Verify at the official NPI Registry.