Blue Agave Functional Medicine Boerne PLLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

BLUE AGAVE FUNCTIONAL MEDICINE BOERNE PLLC

Practice address

5 Coughran Rd Ste 101
Boerne, TX 78006-8103

Phone

(830) 491-4040

Fax

(833) 468-4963

NPI assigned

Jan 8, 2026

Organization subpart

No

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

Authorized official

Name

Scott P Knepper, MD

Title

Medical Director

Phone

(512) 293-9800

Specialties & licenses 1

Addresses

Other names 1

• Blue Agave Functional Medicine Clinic Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Janice Yates, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Boerne, TX
  • NPI 1164603791
  NPD (past)

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

{
    "created_epoch": "1767830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786579200000",
    "number": "1235096447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 COUGHRAN RD # 101",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780068103",
            "telephone_number": "830-491-4040",
            "fax_number": "833-468-4963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 COUGHRAN RD STE 101",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780068103",
            "telephone_number": "830-491-4040",
            "fax_number": "833-468-4963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE AGAVE FUNCTIONAL MEDICINE BOERNE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-08",
        "last_updated": "2026-08-13",
        "certification_date": "2026-08-13",
        "status": "A",
        "authorized_official_last_name": "KNEPPER",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "512-293-9800",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blue Agave Functional Medicine Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Keyur Bhagat, D.D.S.
• BHS Physicians Network, Inc
• Conan James Bicknell, RBT
• Patsy Dawn Bledsoe, AUD
• Bloom Physical Therapy & Wellness PLLC
• Blue Star Imaging Sa, LLC
• Bluebonnet Pediatric Therapy LLC
• Blueprint Therapy Services
• Boerne Anesthesia Associates, PLLC
• Boerne Caregiving Company LLC

• General Practice Physician in Boerne, TX
• Providers in Boerne, TX by specialty
• General Practice Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.