BLUE AGAVE FUNCTIONAL MEDICINE BOERNE PLLC – NPI #1235096447
General Practice

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

Health Care Provider Taxonomy Code for General Practice

BLUE AGAVE FUNCTIONAL MEDICINE BOERNE PLLC is a provider located in BOERNE, TX. NPPES has assigned the NPI number 1235096447 to BLUE AGAVE FUNCTIONAL MEDICINE BOERNE PLLC on January 08, 2026. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 208D00000X from the Health Care Provider Taxonomy code set, which is classified as General Practice.

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for BLUE AGAVE FUNCTIONAL MEDICINE BOERNE PLLC below.

NPI Profile for
BLUE AGAVE FUNCTIONAL MEDICINE BOERNE PLLC

NPI Number
1235096447
Enumeration Date

(about 5 months ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
BLUE AGAVE FUNCTIONAL MEDICINE BOERNE PLLC
Primary location
5 COUGHRAN RD STE 101
BOERNE, TX 78006-8103
Phone: (512) 293-9800 Fax:
Mailing address
3321 WHITT PARK PATH
LEANDER, TX 78641-3975
Phone: Fax:
Organization Subpart
No
Authorized Official
SCOTT KNEPPER
MEDICAL DIRECTOR
Phone: (512) 293-9800
Updated
Certification Date
Jan 08, 2026

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
208D00000X
- General Practice (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.