Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

BLUE AGAVE FUNCTIONAL MEDICINE BOERNE PLLC
NPI 1235096447
General Practice in Boerne, TX

Q: What is Blue Agave Functional Medicine Boerne PLLC's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Active since January 08, 2026

5 COUGHRAN RD STE 101, BOERNE, TX 78006(830) 491-4040(833) 468-4963 Get Directions Write a Review

NPPES record last updated: August 13, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 13, 2026, Jan 8, 2026 (2 updates tracked since 2026).

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About Blue Agave Functional Medicine Boerne Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BLUE AGAVE FUNCTIONAL MEDICINE BOERNE PLLC (NPI 1235096447), doing business as Blue Agave Functional Medicine Clinic, is a healthcare organization registered as a general practice in Boerne, Texas and active in the NPI registry since January 2026. The organization lists Scott P Knepper, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1235096447

Entity TypeOrganization

Primary Taxonomy208D00000X

Legal Business NameBLUE AGAVE FUNCTIONAL MEDICINE BOERNE PLLC

Location Address5 COUGHRAN RD STE 101Boerne, TX 78006-8103

Mailing Address5 Coughran Rd # 101Boerne, TX 78006-8103 · (830) 491-4040 · Fax (833) 468-4963

Phone(830) 491-4040

Fax(833) 468-4963

Organization SubpartNo

Authorized OfficialScott P KnepperMedical Director · (512) 293-9800

Enumeration DateJanuary 8, 2026

Last NPPES UpdateAugust 13, 20262 updates tracked since enumeration

NPPES CertifiedAugust 13, 2026

✔ NPI 1235096447 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians

Taxonomy Code208D00000X

Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

5 COUGHRAN RD STE 101, Boerne, TX 78006

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Other Names 1

Doing Business AsBlue Agave Functional Medicine Clinic

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. JANICE YATES PHYSICIAN ASSISTANT

Physician Assistant

5 COUGHRAN RD STE 101
BOERNE, TX 78006

Kendall County (830) 491-4040

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Blue Agave Functional Medicine Boerne PLLC's NPI number?

The NPI number for Blue Agave Functional Medicine Boerne PLLC is 1235096447. It was assigned to this organization in the NPPES registry on January 8, 2026. The provider is doing business as Blue Agave Functional Medicine Clinic.

Where is Blue Agave Functional Medicine Boerne PLLC located?

Blue Agave Functional Medicine Boerne PLLC is located at 5 Coughran Rd Ste 101, Boerne, TX 78006. The listed phone number is (830) 491-4040.

What is Blue Agave Functional Medicine Boerne PLLC's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

When was this NPI record last updated?

The NPPES record for Blue Agave Functional Medicine Boerne PLLC was last updated on August 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.