Blue Agave Functional Medicine Boerne PLLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

BLUE AGAVE FUNCTIONAL MEDICINE BOERNE PLLC

Doing business as

Blue Agave Functional Medicine Clinic

Practice address

5 Coughran Rd Ste 101
Boerne, TX 78006-8103

Phone

(830) 491-4040

Fax

(833) 468-4963

NPI assigned

Jan 8, 2026

Last updated

Aug 13, 2026By the provider in NPPES

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, MDNPI 1013353747

Title

Medical Director

Phone

(512) 293-9800

Specialties & licenses 1

Addresses

Other names 1

• Blue Agave Functional Medicine Clinic Doing business as

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Scott P Knepper, M.D.

  • General Practice Physician
  • New Braunfels, TX
  • NPI 1013353747
  NPD Authorized official
• Troy Green, PA-C

  • Physician Assistant
  • Lakeway, TX
  • NPI 1205297082
  NPD
• Janice Yates, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Boerne, TX
  • NPI 1164603791
  NPD

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.
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• 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 (The Caregiving Company)

• 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.